Organization Active NPI

Charlotte Orthopaedic Clinic Professional Association

  • Orthopaedic Surgery Physician
  • Port Charlotte, FL
National Provider Identifier
1952350977
Registry record updated Aug 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CHARLOTTE ORTHOPAEDIC CLINIC PROFESSIONAL ASSOCIATION
Practice address
4161 Tamiami TRL
Unit 101
Port Charlotte, FL 33952-9204
Phone
(941) 625-0984
Fax
(941) 625-0877
NPI assigned
May 8, 2006
Last updated
Aug 5, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2013

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

Authorized official

Name
Ms. Elizabeth Renee McLure
Title
Practice Administrator
Phone
(941) 625-0984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X NU Primary

Addresses

Primary practice location

4161 Tamiami TRL
Unit 101
Port Charlotte, FL 33952-9204

Mailing address

4161 Tamiami TRL
Unit 101
Port Charlotte, FL 33952-9204
Phone (941) 625-0984

Other identifiers 8

IdentifierTypeStateIssuer
7323528-002OtherFLCIGNA-PAL
DE0219OtherFLRR MEDICARE
1596302000OtherFLDEPT OF LABOR
77674OtherFLBLUE CROSS BLUE SHIELD
K2675OtherFLMEDICARE
0886990001OtherFLPALMETTO
4639456OtherFLAETNA
DE0219OtherFLRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

900 N Robert Ave
Fl 2
Arcadia, FL 34266
Phone (863) 884-2363

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": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375660800000",
    "number": "1952350977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4161 TAMIAMI TRL",
            "address_2": "UNIT 101",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529204",
            "telephone_number": "941-625-0984",
            "fax_number": "941-625-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 TAMIAMI TRL",
            "address_2": "UNIT 101",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529204",
            "telephone_number": "941-625-0984",
            "fax_number": "941-625-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE ORTHOPAEDIC CLINIC PROFESSIONAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2013-08-05",
        "status": "A",
        "authorized_official_last_name": "MCLURE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "941-625-0984",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA-PAL",
            "identifier": "7323528-002",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DE0219",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "1596302000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "77674",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K2675",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO",
            "identifier": "0886990001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4639456",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE0219",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2013; 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.