Provider Demographics
NPI:1033160676
Name:ORTHOPAEDIC CONSULTANTS LTD
Entity Type:Organization
Organization Name:ORTHOPAEDIC CONSULTANTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LAVONNE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-336-2638
Mailing Address - Street 1:2908 E 26TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-4034
Mailing Address - Country:US
Mailing Address - Phone:605-336-2638
Mailing Address - Fax:605-334-3500
Practice Address - Street 1:2908 E 26TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-4034
Practice Address - Country:US
Practice Address - Phone:605-336-2638
Practice Address - Fax:605-334-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2018-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0012207X00000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB3741Medicare PIN
SDS110998Medicare PIN
SD1107050001Medicare NSC
MNH100323220Medicare PIN
IA0000066OtherBLUE CROSS
MN861210200Medicaid
SD=========OtherTAX ID
IA0105676Medicaid
NE=========13Medicaid
IAI14037Medicare PIN
SDS66Medicare PIN