Orthopedic Specialties of Spartanburg LLC
Organization Active NPI Orthopaedic Surgery Physician · Spartanburg, SC
NPI 1851348403 · NPPES record last updated Sep 13, 2022
Key facts
- NPI
- 1851348403
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- ORTHOPEDIC SPECIALTIES OF SPARTANBURG LLC
- Practice address
- 303 E Wood Street
Spartanburg, SC 29303 - Phone
- (864) 208-8800
- Fax
- (864) 208-0318
- NPI assigned
- May 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Karen F Barnes
- Title
- Practice Manager
- Phone
- (864) 208-8809
Practitioners 11
-
Danni Moss Borron, PT, DPT
-
Ryan Thomas Hudson, M.D.
-
Mary B Taylor, DPT
-
Skylar K Davis, PA
-
Anthony Ty Medlin, PA-C
-
Julia Le, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060622000020 | SC | Part B Supplier - Clinic/Group Practice | 8224040969 |
Receives reassigned benefits from 11 practitioners Practice locations: Spartanburg, SC |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes | ||
| Orthopaedic Surgery of the Spine Physician |
207XS0117X | |||
| Physical Medicine & Rehabilitation Physician |
208100000X |
Addresses
Primary practice location
303 E Wood Street
Spartanburg, SC 29303
Mailing address
303 E Wood Street
Spartanburg, SC 29303
Phone (864) 208-8800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DE2877 | Other | SC | MEDICAID DME |
| GP3071 | Medicaid | SC |
Other providers in Spartanburg, SC
- Caitlyn Orders
- Orin Community Health Center Inc.
- Richard Kenneth Orr
- Michael J Orseck
- Ortho Sport & Spine Physicians Spartanburg
- Orthopedic Specialties of Spartanburg,PC
- Juan Francisco Ortiz Rodriguez
- Noah Johann Ostlund
- Gabriel Dan Osullivan
- Madison Oswald
All providers in Spartanburg, SC · Orthopaedic Surgery Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.