Organization Active NPI

Orthopaedic Associates of Brazos Valley PLLC

  • Orthopaedic Surgery Physician
  • Bryan, TX
National Provider Identifier
1851742779
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPAEDIC ASSOCIATES OF BRAZOS VALLEY PLLC
Practice address
3201 University Dr E Ste 175
Bryan, TX 77802-3480
Phone
(979) 704-6420
Fax
(979) 704-6592
NPI assigned
Jun 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Authorized official

Name
Dr. Wade Whitmer, MDNPI 1073668091
Title
Physician
Phone
(979) 704-6420

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

3201 University Dr E Ste 175
Bryan, TX 77802-3480

Mailing address

3201 University Dr E Ste 175
Bryan, TX 77802-3480
Phone (979) 704-6420

Other identifiers 1

IdentifierTypeStateIssuer
363221801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160816002136 TX Part B Supplier - Clinic/Group Practice 3274827167 Receives reassigned benefits from 1 practitioner
Practice locations: Bryan, TX

National Provider Directory

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.

NPI Registry JSON

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1851742779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E STE 175",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023480",
            "telephone_number": "979-704-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 UNIVERSITY DR E STE 175",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023480",
            "telephone_number": "979-704-6420",
            "fax_number": "979-704-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC ASSOCIATES OF BRAZOS VALLEY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "WHITMER",
        "authorized_official_first_name": "WADE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "979-704-6420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363221801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.