Active NPI
Orthopedic Specialists, Inc.
- Orthopaedic Surgery Physician
- Marion, IN
National Provider Identifier
1790812899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- Legal business name
- ORTHOPEDIC SPECIALISTS, INC.
- Practice address
- 1389 N Baldwin Ave
Marion, IN 46952-1913 - Phone
- (765) 662-3300
- Fax
- (765) 651-4282
- NPI assigned
- Feb 27, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Robert Franklin Jackson II, D.O.
- Title
- President
- Phone
- (765) 662-3300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | Primary |
Addresses
Primary practice location
1389 N Baldwin Ave
Marion, IN 46952-1913
Mailing address
1389 N Baldwin Ave
Marion, IN 46952-1913
Phone (765) 662-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100352320 | Medicaid | IN |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1250640000000",
"number": "1790812899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1389 N BALDWIN AVE",
"city": "MARION",
"state": "IN",
"postal_code": "469521913",
"telephone_number": "765-662-3300",
"fax_number": "765-651-4282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1389 N BALDWIN AVE",
"city": "MARION",
"state": "IN",
"postal_code": "469521913",
"telephone_number": "765-662-3300",
"fax_number": "765-651-4282"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORTHOPEDIC SPECIALISTS, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-27",
"last_updated": "2009-08-19",
"status": "A",
"authorized_official_last_name": "JACKSON",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "FRANKLIN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "765-662-3300",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "II",
"authorized_official_credential": "D.O."
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100352320",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.