NPIMap

Organization Active NPI

Southern Orthopaedic Surgeons, LLC

  • Orthopaedic Surgery Physician
  • Montgomery, AL
National Provider Identifier
1861432239
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
SOUTHERN ORTHOPAEDIC SURGEONS, LLC
Practice address
454 Taylor Rd
Montgomery, AL 36117-3563
Phone
(334) 613-9000
Fax
(334) 286-6311
NPI assigned
Jun 7, 2006
Last updated
Mar 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Authorized official

Name
Dr. Roland A Hester IV, M.D.NPI 1184684334
Title
President
Phone
(334) 613-9000

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 Physician 207X00000X Primary

Addresses

Primary practice location

454 Taylor Rd
Montgomery, AL 36117-3563

Mailing address

454 Taylor Rd
Montgomery, AL 36117-3563
Phone (334) 613-9000

Other identifiers 1

IdentifierTypeStateIssuer
529700340MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051026001043 AL Part B Supplier - Clinic/Group Practice 9335166685 Receives reassigned benefits from 33 practitioners
Practice locations: Prattville, AL; Wetumpka, AL; Tallassee, AL; Montgomery, AL

Other NPIs with the same Medicare PAC ID 5

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

National Provider Directory

National Provider Directory

Locations

668 McQueen Smith Rd N
Prattville, AL 36066

80 Herren Hill Rd
Ste G
Tallassee, AL 36078

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1861432239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "454 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173563",
            "telephone_number": "334-613-9000",
            "fax_number": "334-286-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "454 TAYLOR RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173563",
            "telephone_number": "334-613-9000",
            "fax_number": "334-286-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN ORTHOPAEDIC SURGEONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "HESTER",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-613-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529700340",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.