1063507226 NPI number — ORTHOPEDIC & NEUROLOGICAL CONSULTANTS, INC.

Table of content: (NPI 1063507226)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063507226 NPI number — ORTHOPEDIC & NEUROLOGICAL CONSULTANTS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ORTHOPEDIC & NEUROLOGICAL CONSULTANTS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ORTHONEURO
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063507226
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
70 S. CLEVELAND AVE.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTERVILLE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43081-1397
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-890-6555
Provider Business Mailing Address Fax Number:
614-823-8881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5040 FOREST DRIVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
NEW ALBANY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-890-6555
Provider Business Practice Location Address Fax Number:
614-823-8881
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BERASI
Authorized Official First Name:
CARL
Authorized Official Middle Name:
C
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
614-890-6555

Provider Taxonomy Codes

  • Taxonomy code: 207PS0010X , with the licence number:  35.062312 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207T00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207XS0106X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XS0117X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XX0004X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0400X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0014X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AM0700X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0259778 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0438480005 . This is a "DME" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0438480003 . This is a "DME" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0438480002 . This is a "DME" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 0438480004 . This is a "DME" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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