NPIMap

Organization Active NPI

Southeastern Orthopaedic Specialists, PA

Doing business as Guilford Orthopaedic & Sports Medicine Ctr

  • Orthopaedic Surgery Physician
  • Greensboro, NC
National Provider Identifier
1790724706
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SOUTHEASTERN ORTHOPAEDIC SPECIALISTS, PA
Doing business as
Guilford Orthopaedic & Sports Medicine Ctr
Practice address
1915 Lendew St
Greensboro, NC 27408-7033
Phone
(336) 275-3325
Fax
(336) 275-5346
NPI assigned
Jun 5, 2006
Last updated
Jun 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Authorized official

Name
Frank J Rowan, MDNPI 1174566632
Title
Senior Partner
Phone
(336) 275-3325

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X
Orthopaedic Surgery Physician 207X00000X Primary
Orthopaedic Surgery of the Spine Physician 207XS0117X

Addresses

Primary practice location

1915 Lendew St
Greensboro, NC 27408-7033

Mailing address

1915 Lendew St
Greensboro, NC 27408-7033
Phone (336) 275-3325

Other identifiers 1

IdentifierTypeStateIssuer
890180GMedicaidNC

Other names 1

  • Guilford Orthopaedic & Sports Medicine Ctr Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031121000719 NC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4587568472 Receives reassigned benefits from 3 practitioners
Practice locations: Greensboro, NC
O20040225000980 NC Part B Supplier - Clinic/Group Practice 4587568472 Receives reassigned benefits from 28 practitioners
4 other NPIs on this enrollment
Practice locations: Eden, NC; Greensboro, NC
O20100930045296 NC DME Supplier - Physician - Orthopedic/Orthopedic Surgery 4587568472 Practice locations: Greensboro, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 39

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.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1790724706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 LENDEW ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087033",
            "telephone_number": "336-275-3325",
            "fax_number": "336-275-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 LENDEW ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087033",
            "telephone_number": "336-275-3325",
            "fax_number": "336-275-5346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN ORTHOPAEDIC SPECIALISTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "ROWAN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SENIOR PARTNER",
        "authorized_official_telephone_number": "336-275-3325",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890180G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Guilford Orthopaedic & Sports Medicine Ctr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.