Northland Orthopedic Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

12261963 Issued in MO

Legal business name

NORTHLAND ORTHOPEDIC GROUP

Doing business as

Northland Midamerica Orthopedics

Practice address

1150 Graham Rd
Ste 102
Florissant, MO 63031-8077

Phone

(314) 837-5555

Fax

(314) 837-6175

NPI assigned

Jul 24, 2006

Last updated

Dec 7, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Randall D Roush, MD

Title

President

Phone

(314) 837-5555

Specialties & licenses 1

Addresses

Other names 1

• Northland Midamerica Orthopedics Doing business as

Locations

Practitioners 2

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.

• Jody T Jachna, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Saint Charles, MO
  • NPI 1891728051
  NPD (past)
• Terry J Weis, DO

  • Orthopaedic Surgery Physician
  • Bridgeton, MO
  • NPI 1154347995
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260144000000",
    "number": "1891717351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 GRAHAM RD STE 102",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318077",
            "telephone_number": "314-837-5555",
            "fax_number": "314-837-6175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 GRAHAM RD",
            "address_2": "STE 102",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318077",
            "telephone_number": "314-837-5555",
            "fax_number": "314-837-6175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND ORTHOPEDIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2009-12-07",
        "status": "A",
        "authorized_official_last_name": "ROUSH",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-837-5555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "12261963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northland Midamerica Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Fredricka Norwood
• NP Health Information Station LLC
• Nu-Crown, LLC (Crown Optical)
• Nurses That Care Home Health Services LLC
• Nurses That Care in Home Health Services LLC

• Specialist in Florissant, MO
• Providers in Florissant, MO by specialty
• Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2009; 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.