NPIMap

Organization Active NPI

Synergy Orthopedic Specialists, Inc.

  • Specialist
  • San Diego, CA
National Provider Identifier
1902494693
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SYNERGY ORTHOPEDIC SPECIALISTS, INC.
Practice address
4445 Eastgate Mall Ste 103
San Diego, CA 92121-1979
Phone
(858) 450-7118
Fax
(858) 450-7119
NPI assigned
Jan 7, 2021
Organization subpart
Yes
Parent organization
SYNERGY ORTHOPEDIC SPECIALISTS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Authorized official

Name
Meghan Thomas
Title
Credentialing Specialist
Phone
(858) 412-6080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

4445 Eastgate Mall Ste 103
San Diego, CA 92121-1979

Mailing address

4445 Eastgate Mall Ste 105
San Diego, CA 92121-1979
Phone (858) 412-6080

Other names 1

  • Synergy Specialists Medical Group, Inc. Former legal business name

National Provider Directory

National Provider Directory
Part of
Synergy Orthopedic Specialists Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640217600000",
    "number": "1902494693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 EASTGATE MALL STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211979",
            "telephone_number": "858-412-6080",
            "fax_number": "858-412-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 EASTGATE MALL STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211979",
            "telephone_number": "858-450-7118",
            "fax_number": "858-450-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY ORTHOPEDIC SPECIALISTS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SYNERGY ORTHOPEDIC SPECIALISTS, INC.",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-21",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "MEGHAN",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "858-412-6080"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Specialists Medical Group, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Synergy Specialists Medical Group, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.