NPIMap

Organization Active NPI

Southern Orthopedic Associates, S.C.

Doing business as Orthopedic Institute of Western Kentucky

  • Orthopaedic Surgery Physician
  • Paducah, KY
National Provider Identifier
1740598390
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
042.617215 Issued in IL
Legal business name
SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.
Doing business as
Orthopedic Institute of Western Kentucky
Practice address
3530 Lone Oak Rd
Suite a
Paducah, KY 42003-5752
Phone
(270) 554-0505
Fax
(270) 554-0905
NPI assigned
Sep 16, 2010
Last updated
Sep 30, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Authorized official

Name
Dr. Thomas West DavisNPI 1295842870
Title
President
Phone
(618) 997-6800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 042617215 IL
Orthopaedic Surgery Physician 207X00000X 042.617215 IL Primary

Addresses

Primary practice location

3530 Lone Oak Rd
Suite a
Paducah, KY 42003-5752

Mailing address

510 Lincoln Dr
Herrin, IL 62948-6334
Phone (618) 997-6800

Other names 1

  • Orthopedic Institute of Western Kentucky Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Ortho Assoc PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285804800000",
    "number": "1740598390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 LINCOLN DR",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629486334",
            "telephone_number": "618-997-6800",
            "fax_number": "618-998-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3530 LONE OAK RD",
            "address_2": "SUITE A",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420035752",
            "telephone_number": "270-554-0505",
            "fax_number": "270-554-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-30",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "WEST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-997-6800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "042617215",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "042.617215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopedic Institute of Western Kentucky",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.