Provider Demographics
NPI:1720163512
Name:ORTHOPARTNERS INC
Entity type:Organization
Organization Name:ORTHOPARTNERS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-397-0993
Mailing Address - Street 1:2534 EMPIRE DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-6710
Mailing Address - Country:US
Mailing Address - Phone:336-397-2165
Mailing Address - Fax:336-397-2167
Practice Address - Street 1:15301 SPECTRUM DR
Practice Address - Street 2:SUITE 175
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4665
Practice Address - Country:US
Practice Address - Phone:972-980-9660
Practice Address - Fax:972-980-9313
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101332335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1796674Medicaid
TX5594040001Medicare NSC