Granite City Orthopedic Physicians Company LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GRANITE CITY ORTHOPEDIC PHYSICIANS COMPANY LLC

Doing business as

Illinois SW Orthopedics

Practice address

4802 S State Route 159
Glen Carbon, IL 62034-1904

Phone

(618) 288-4388

Fax

(618) 288-4927

NPI assigned

Nov 8, 2007

Last updated

Jul 7, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

GRANITE CITY ORTHOPEDIC PHYSICIANS COMPANY LLCAs reported in NPPES

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

Authorized official

Name

Laura J Fey

Title

Sr. Director Physician Rev Cycle

Phone

(615) 221-3641

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Illinois SW Orthopedics Doing business as

Part of

Granite City Ortho Co LLC

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

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688688000000",
    "number": "1861672677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4802 S STATE ROUTE 159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341904",
            "telephone_number": "618-288-4388",
            "fax_number": "618-288-4927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4802 S STATE ROUTE 159",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341904",
            "telephone_number": "618-288-4388",
            "fax_number": "618-288-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE CITY ORTHOPEDIC PHYSICIANS COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GRANITE CITY ORTHOPEDIC PHYSICIANS COMPANY LLC",
        "enumeration_date": "2007-11-08",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A",
        "authorized_official_last_name": "FEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SR. DIRECTOR PHYSICIAN REV CYCLE",
        "authorized_official_telephone_number": "615-221-3641"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "6032134",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "504042508",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Illinois SW Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Illinois SW Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandra Lynn Goss, RBT
• Michael Francis Gowen, MD
• Marissa Gowey, PHD
• Granite City Illinois Hospital Company LLC (Gateway Urgent Care)
• Granite City Orthopedic Physicians Company LLC (Illinois SW Orthopedics LTD)
• Quinisa Grant
• Haileigh Marie Gray, RBT
• Harriet Grazman, LCSW
• Esther Green
• Kiera Alexis Green

• Durable Medical Equipment & Medical Supplies in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; 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.