Provider Demographics
NPI:1780672709
Name:ORTHOPEDIC GROUP, INC.
Entity Type:Organization
Organization Name:ORTHOPEDIC GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:RHOADES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-722-2400
Mailing Address - Street 1:588 PAWTUCKET AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6057
Mailing Address - Country:US
Mailing Address - Phone:401-722-2400
Mailing Address - Fax:401-728-3920
Practice Address - Street 1:588 PAWTUCKET AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6057
Practice Address - Country:US
Practice Address - Phone:401-722-2400
Practice Address - Fax:401-728-3920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIOG03860Medicaid
MA9763139Medicaid
MAPT0094Medicare ID - Type UnspecifiedOCCUPATIONAL THERAPY GRP
RIOG03860Medicaid
MAM15258Medicare ID - Type Unspecified