Provider Demographics
NPI:1245556091
Name:HEALTHONE CLINIC SERVICES - ORTHOPEDIC SPECIALISTS LLC
Entity type:Organization
Organization Name:HEALTHONE CLINIC SERVICES - ORTHOPEDIC SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:REBOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-372-5004
Mailing Address - Street 1:2000 HEALTH PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4692
Mailing Address - Country:US
Mailing Address - Phone:615-373-7600
Mailing Address - Fax:
Practice Address - Street 1:11230 BENTON ST
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80020-3275
Practice Address - Country:US
Practice Address - Phone:303-453-2997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-19
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO94473889Medicaid
CO94922080Medicaid
NE1245556091Medicaid
CO56473362Medicaid
CO57327262Medicaid
WY129802000Medicaid
KS200685190BMedicaid
CO38882388Medicaid
CO68975287Medicaid
CO14203286Medicaid
WY1245556091Medicaid
CO23752581Medicaid
CO96071389Medicaid
KS200685190BMedicaid
CO94922080Medicaid