Effingham Orthopedic Clinic SC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036064071 Issued in IL

Legal business name

EFFINGHAM ORTHOPEDIC CLINIC SC

Practice address

802 E Jefferson Ave
Effingham, IL 62401-3409

Phone

(217) 347-5305

Fax

(217) 347-5305

NPI assigned

Jun 22, 2005

Organization subpart

No

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

Authorized official

Name

Behrooz Heshmatpour, M.D.

Title

President

Phone

(217) 347-5305

Specialties & licenses 1

Addresses

Other identifiers 6

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247011200000",
    "number": "1912903261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 E JEFFERSON AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624013409",
            "telephone_number": "217-347-5305",
            "fax_number": "217-347-5305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 E JEFFERSON AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624013409",
            "telephone_number": "217-347-5305",
            "fax_number": "217-347-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EFFINGHAM ORTHOPEDIC CLINIC SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2009-07-08",
        "status": "A",
        "authorized_official_last_name": "HESHMATPOUR",
        "authorized_official_first_name": "BEHROOZ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-347-5305",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036064071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "02500061",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "137805",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "078985",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS OWCP",
            "identifier": "133294100",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036064071",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "200000910",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Effingham Healthcare & Senior Living LLC
• Effingham Obstetrics & Gynecology Associates SC
• Effingham Obstetrics and Gynecology Associates PLLC
• Effingham Open MRI, LLC
• Effingham Ophthalmology Associates, LTD.
• Effingham Pelvic Health & Wellness, PLLC
• Effingham Sleep Center, Inc
• Effingham Suites, LLC
• Effingham Urology Associates,S.C.
• James Ellis, D.O., FACEP

• Orthopaedic Surgery Physician in Effingham, IL
• Providers in Effingham, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.