Organization Active NPI

Ora Orthopedics, PC

  • Orthopaedic Surgery Physician
  • Muscatine, IA
National Provider Identifier
1730150038
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
060006850 Issued in IL
Legal business name
ORA ORTHOPEDICS, PC
Practice address
1608 Cedar St
Suite a
Muscatine, IA 52761-3466
Phone
(563) 264-5750
Fax
(563) 264-5751
NPI assigned
Jan 27, 2006
Last updated
Dec 9, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
ORA ORTHOPEDICS, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenneth Brockman
Title
Ceo
Phone
(563) 322-0971

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 060006850 IL Primary
Other Specialist/Technologist 246Z00000X NU
Durable Medical Equipment & Medical Supplies 332B00000X NU
Prosthetic/Orthotic Supplier 335E00000X NU

Addresses

Primary practice location

1608 Cedar St
Suite a
Muscatine, IA 52761-3466

Mailing address

2300 53Rd Ave
Suite 100
Bettendorf, IA 52722-7564
Phone (563) 322-0971

Other identifiers 1

IdentifierTypeStateIssuer
0073734MedicaidIA

National Provider Directory

National Provider Directory
Part of
Moline Orthopedics Asso

Locations

1608 Cedar St
Ste A
Muscatine, IA 52761
Phone (563) 264-5750

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1730150038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 53RD AVE",
            "address_2": "SUITE 100",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527227564",
            "telephone_number": "563-322-0971",
            "fax_number": "563-324-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 CEDAR ST",
            "address_2": "SUITE A",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527613466",
            "telephone_number": "563-264-5750",
            "fax_number": "563-264-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORA ORTHOPEDICS, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORA ORTHOPEDICS, PC",
        "enumeration_date": "2006-01-27",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "BROCKMAN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "563-322-0971"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "060006850",
            "primary": true
        },
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0073734",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muscatine, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.