Jack Charles Purdy, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

00G313870 Issued in CA

Practice address

17337 Tramonto Dr
Unit 210
Pacific Palisades, CA 90272-3121

Phone

(310) 453-3533

Fax

(310) 828-8038

NPI assigned

Dec 19, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1801872155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17337 TRAMONTO DR",
            "address_2": "UNIT 210",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723121",
            "telephone_number": "310-453-3533",
            "fax_number": "310-828-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17337 TRAMONTO DR",
            "address_2": "UNIT 210",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902723121",
            "telephone_number": "310-453-3533",
            "fax_number": "310-828-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURDY",
        "first_name": "JACK",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "00G313870",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "27526938",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee S. Portenier, OTR
• David Vincent Powers, P.T.
• Thomas Harrison Price, RPH
• Gena Sloane Pruetz, P.T.
• Nathan Pruitt, RPH
• Sadaf Radnia, PHARMD
• Rancho Physical Therapy, Inc.
• Damon Bradley Raskin, MD
• Reconnect Psychological Services
• Nasser Redjal, M.D.

• Orthopaedic Surgery Physician in Pacific Palisades, CA
• Providers in Pacific Palisades, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; 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.