Organization Active NPI

Orthopaedic & Spine Surgery Associates LLC

  • Orthopaedic Surgery Physician
  • Beckley, WV
National Provider Identifier
1922118272
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
ORTHOPAEDIC & SPINE SURGERY ASSOCIATES LLC
Practice address
215 Brookshire LN
Beckley, WV 25801-6729
Phone
(304) 253-1077
Fax
(304) 253-9611
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Authorized official

Name
Connie S Link
Title
Office Manager
Phone
(304) 253-1077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

215 Brookshire LN
Beckley, WV 25801-6729

Mailing address

215 Brookshire LN
Beckley, WV 25801-6729
Phone (304) 253-1077

Other identifiers 2

IdentifierTypeStateIssuer
00176228OtherWVBCBS
3810002820MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110223000611 WV DME Supplier - Physician - General Surgery 1951330869 Practice locations: Beckley, WV

National Provider Directory

National Provider Directory

Locations

1007 S Oakwood Ave
Ste 1000
Beckley, WV 25801
Phone (304) 253-1077

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433462400000",
    "number": "1922118272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BROOKSHIRE LN",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016729",
            "telephone_number": "304-253-1077",
            "fax_number": "304-253-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 BROOKSHIRE LN",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258016729",
            "telephone_number": "304-253-1077",
            "fax_number": "304-253-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC & SPINE SURGERY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-06-05",
        "status": "A",
        "authorized_official_last_name": "LINK",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-253-1077"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00176228",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810002820",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beckley, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.