NPIMap

Organization Active NPI

Comprehensive Orthopedics, P. C.

  • Specialist
  • Peoria, IL
National Provider Identifier
1902040124
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
060007948 Issued in IL
Legal business name
COMPREHENSIVE ORTHOPEDICS, P. C.
Practice address
5401 North Knoxville Ave
Suite 400
Peoria, IL 61614-5021
Phone
(309) 692-6644
Fax
(309) 692-8992
NPI assigned
May 1, 2009
Last updated
Mar 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Authorized official

Name
Dr. George W. Lane Sr., M.D.NPI 1740227032
Title
President
Phone
(309) 692-6644

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 060007948 IL Primary

Addresses

Primary practice location

5401 North Knoxville Ave
Suite 400
Peoria, IL 61614-5021

Mailing address

5401 North Knoxville Ave
Suite 400
Peoria, IL 61614-5021
Phone (309) 692-6644

Other identifiers 6

IdentifierTypeStateIssuer
050053OtherILHEALTH ALLIANCE
060007948OtherILSTATE LICENSE
060007948MedicaidIL
7230175OtherILBLUE CROSS BLUE SHIELD
368270100OtherILOWCP DEPARTMENT OF LABORR
CH8612OtherILRR MEDICARE

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1241136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1902040124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 NORTH KNOXVILLE AVE",
            "address_2": "SUITE 400",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145021",
            "telephone_number": "309-692-6644",
            "fax_number": "309-692-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 NORTH KNOXVILLE AVE",
            "address_2": "SUITE 400",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145021",
            "telephone_number": "309-692-6644",
            "fax_number": "309-692-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE ORTHOPEDICS, P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-01",
        "last_updated": "2010-03-18",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-692-6644",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "060007948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "050053",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "060007948",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060007948",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "7230175",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP DEPARTMENT OF LABORR",
            "identifier": "368270100",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CH8612",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.