Active NPI
Ora Orthopedics PC
- Orthopaedic Surgery Physician
- Moline, IL
National Provider Identifier
1962481861
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 060006850
- Legal business name
- ORA ORTHOPEDICS PC
- Practice address
- 520 Valley View Dr
Moline, IL 61265-6194 - Phone
- (309) 762-3621
- Fax
- (309) 762-3690
- NPI assigned
- Jan 10, 2006
- Last updated
- May 20, 2026
- Organization subpart
- Yes
- Parent organization
- ORA ORTHOPEDICS PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenneth Brockman
- Title
- Ceo
- Phone
- (309) 762-3621
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | |||
| Sports Medicine (Family Medicine) Physician | 207QS0010X | |||
| Rheumatology Physician | 207RR0500X | |||
| Orthopaedic Surgery Physician | 207X00000X | 060006850 | IL | Primary |
| Orthopaedic Hand Surgery Physician | 207XS0106X | |||
| Clinical Neurophysiology Physician | 2084N0600X | |||
| Foot & Ankle Surgery Podiatrist | 213ES0103X | |||
| Other Technician | 247200000X | |||
| Urgent Care Clinic/Center | 261QU0200X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Prosthetic/Orthotic Supplier | 335E00000X | |||
| Medical Physician Assistant | 363AM0700X | |||
| Surgical Physician Assistant | 363AS0400X | |||
| Nurse Practitioner | 363L00000X | |||
| Surgical Technologist | 246ZS0410X |
Addresses
Primary practice location
520 Valley View Dr
Moline, IL 61265-6194
Mailing address
520 Valley View Dr
Moline, IL 61265-6194
Phone (309) 762-3621
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 58091 | Other | IA | WELLMARK |
| 58109 | Other | IA | WELLMARK |
| 57821 | Other | IA | WELLMARK |
| 37772 | Other | IA | WELLMARK |
| 92231 | Other | IA | WELLMARK |
| 58104 | Other | IA | WELLMARK |
| 8121085 | Other | IL | BCBS-IL |
| CN0248 | Other | ID | RR MEDICARE |
| 99204 | Other | IA | WELLMARK |
| CD9661 | Other | IA | RR MEDICARE |
| 0073734 | Medicaid | IA | |
| 91376 | Other | IA | WELLMARK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA, IL
Enrollment records 3
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040216001316 | IA | Part B Supplier - Clinic/Group Practice | 6406741784 |
Receives reassigned benefits from 122 practitioners 2 other NPIs on this enrollment Practice locations: De Witt, IA; Muscatine, IA; Clinton, IA; Bettendorf, IA; Davenport, IA |
| O20040407001036 | IL | Part B Supplier - Clinic/Group Practice | 6406741784 |
Receives reassigned benefits from 123 practitioners 6 other NPIs on this enrollment Practice locations: Geneseo, IL; Moline, IL; Rock Island, IL; Silvis, IL |
| O20100930068751 | IL | DME Supplier - Physician - Orthopedic/Orthopedic Surgery | 6406741784 | Practice locations: Moline, IL |
Other NPIs with the same Medicare PAC ID 8
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba ORA Orthopedics Physical Therapy
- Physical Therapist
- Rock Island, IL
- NPI 1508645680
O20040407001036
National Provider Directory
National Provider Directory- Part of
- Ortho Rheuma Assoc PC
Locations
2300 53rd Ave
Ste LL0
Bettendorf, IA 52722
Phone (563) 441-7608
2300 53rd Ave
Ste LL01
Bettendorf, IA 52722
Phone (563) 441-7608
2300 53rd Ave
Ste LL02
Bettendorf, IA 52722
Phone (563) 332-4422
3565 Utica Ridge Rd
Bettendorf, IA 52722
Phone (563) 441-9982
6101 Northwest Blvd
Davenport, IA 52806
Phone (563) 449-7004
900 14th St
De Witt, IA 52742
Phone (563) 659-1579
Practitioners & affiliated clinicians
Practitioners 178
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.
-
- Orthopaedic Hand Surgery Physician
- Moline, IL
- NPI 1548642580
IA, Orthopaedic Surgery
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779235200000",
"number": "1962481861",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 VALLEY VIEW DR",
"city": "MOLINE",
"state": "IL",
"postal_code": "612656194",
"telephone_number": "309-762-3621",
"fax_number": "309-762-3690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 VALLEY VIEW DR",
"city": "MOLINE",
"state": "IL",
"postal_code": "612656194",
"telephone_number": "309-762-3621",
"fax_number": "309-762-3690"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORA ORTHOPEDICS PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ORA ORTHOPEDICS PC",
"enumeration_date": "2006-01-10",
"last_updated": "2026-05-20",
"certification_date": "2026-05-20",
"status": "A",
"authorized_official_last_name": "BROCKMAN",
"authorized_official_first_name": "KENNETH",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "309-762-3621"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IL",
"license": "060006850",
"primary": true
},
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084N0600X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Clinical Neurophysiology",
"state": null,
"license": null,
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": null,
"license": null,
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QU0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Urgent Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "246ZS0410X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Technologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "58091",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "58109",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "57821",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "37772",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "92231",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "58104",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS-IL",
"identifier": "8121085",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CN0248",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "99204",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CD9661",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0073734",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "91376",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; 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.