| Tallahassee Orthopedic Clinic | |
|
3334 Capital Medical Blvd Ste 400 Tallahassee FL 32308-4470 | |
| (850) 877-8174 | |
| (844) 261-6839 |
| Full Name | Tallahassee Orthopedic Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 3334 Capital Medical Blvd Ste 400, Tallahassee, Florida |
| Authorized Official Name and Position | Allison Powell (MANAGED CARE COORDINATOR) |
| Authorized Official Contact | 8508778174 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tallahassee Orthopedic Clinic 3334 Capital Medical Blvd Ste 400 Tallahassee FL 32308-4470 Ph: (850) 877-8174 | Tallahassee Orthopedic Clinic 3334 Capital Medical Blvd Ste 400 Tallahassee FL 32308-4470 Ph: (850) 877-8174 |
| NPI Number | 1194778050 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 08/14/2024 |
| Certification Date | 08/14/2024 |
| Medicare PECOS PAC ID | 4284532755 |
|---|---|
| Medicare Enrollment ID | O20031222000343 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194778050 | NPI | - | NPPES |
| 251006501 | Medicaid | FL | |
| 251006502 | Medicaid | FL | |
| 251006503 | Medicaid | FL | |
| CG1216 | Other | GA | RAILROAD MEDICARE # |
| 251006500 | Medicaid | FL | |
| CG3489 | Other | GA | RAILROAD MEDICARE |
| 251006512 | Medicaid | FL | |
| 251006509 | Medicaid | FL |
| Provider Name | Aaron J Shores |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1982702643 PECOS PAC ID: 7416922554 Enrollment ID: I20040831001550 |
| Provider Name | Kris D Stowers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043213879 PECOS PAC ID: 4981670122 Enrollment ID: I20040908001622 |
| Provider Name | William H Thompson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1396748125 PECOS PAC ID: 0648247635 Enrollment ID: I20040910000165 |
| Provider Name | Michael W Moser |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1831114586 PECOS PAC ID: 7911974712 Enrollment ID: I20040913000108 |
| Provider Name | Donna L Wheeler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164469326 PECOS PAC ID: 8921067547 Enrollment ID: I20041008000366 |
| Provider Name | Jared J Patterson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508897018 PECOS PAC ID: 2466451174 Enrollment ID: I20061206000524 |
| Provider Name | Kimberly R Hagen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528145356 PECOS PAC ID: 3476554601 Enrollment ID: I20070130000590 |
| Provider Name | Jill David |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336142918 PECOS PAC ID: 5991808834 Enrollment ID: I20070313000454 |
| Provider Name | Mark Edward Fahey |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194728956 PECOS PAC ID: 1456327691 Enrollment ID: I20070317000007 |
| Provider Name | Thomas M Park |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952304792 PECOS PAC ID: 7012939895 Enrollment ID: I20070317000023 |
| Provider Name | Andrew M Wong |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1407859226 PECOS PAC ID: 4789659301 Enrollment ID: I20070317000031 |
| Provider Name | Garrison Anthony Rolle |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1700889540 PECOS PAC ID: 1355317595 Enrollment ID: I20070317000041 |
| Provider Name | David Bellamy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023011905 PECOS PAC ID: 5799743274 Enrollment ID: I20070317000049 |
| Provider Name | Andrew Hicks Borom |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831164904 PECOS PAC ID: 2365545027 Enrollment ID: I20070317000057 |
| Provider Name | David Berg |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1619970589 PECOS PAC ID: 6507848850 Enrollment ID: I20070317000061 |
| Provider Name | Hank Lawrence Hutchinson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518934694 PECOS PAC ID: 7911004486 Enrollment ID: I20070517000245 |
| Provider Name | Aaron J Guyer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780630558 PECOS PAC ID: 6608970884 Enrollment ID: I20071002000178 |
| Provider Name | Hari Parvataneni |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952356941 PECOS PAC ID: 7911900931 Enrollment ID: I20071003000702 |
| Provider Name | Bryan R Prine |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1447330535 PECOS PAC ID: 9739275165 Enrollment ID: I20071017000462 |
| Provider Name | Hector A Mejia |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1417094798 PECOS PAC ID: 8628193216 Enrollment ID: I20100920000968 |
| Provider Name | David Jason Oberste |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1609860451 PECOS PAC ID: 5799977427 Enrollment ID: I20101013000084 |
| Provider Name | Robert Matthias |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1770512949 PECOS PAC ID: 4284639808 Enrollment ID: I20110302000269 |
| Provider Name | Michael Seth Smith |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1134377385 PECOS PAC ID: 3577732536 Enrollment ID: I20110808000652 |
| Provider Name | William Bradford Stephens |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1366527897 PECOS PAC ID: 1456522341 Enrollment ID: I20110926000818 |
| Provider Name | Matthew Christopher Lee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386705283 PECOS PAC ID: 0345419131 Enrollment ID: I20120828000271 |
| Provider Name | Gilbert S Chandler |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1003807272 PECOS PAC ID: 6103878202 Enrollment ID: I20130820000007 |
| Provider Name | Tiffany Cramer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578772448 PECOS PAC ID: 7810217114 Enrollment ID: I20150528001716 |
| Provider Name | Elizabeth Stafford Elchenko |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548577323 PECOS PAC ID: 2062732266 Enrollment ID: I20150528001880 |
| Provider Name | Jason Degroff |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790079515 PECOS PAC ID: 9234441270 Enrollment ID: I20150706001963 |
| Provider Name | Ian David Macdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780063982 PECOS PAC ID: 3971819186 Enrollment ID: I20150902003101 |
| Provider Name | Chancellor Folsom Gray |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013179548 PECOS PAC ID: 1254653447 Enrollment ID: I20150916002212 |
| Provider Name | Drew Bowman Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407280522 PECOS PAC ID: 5799095527 Enrollment ID: I20151106002264 |
| Provider Name | Monica Davila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336599356 PECOS PAC ID: 7315232857 Enrollment ID: I20160823003101 |
| Provider Name | Tony Labree Bryant |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548588072 PECOS PAC ID: 2567603749 Enrollment ID: I20161205001281 |
| Provider Name | Shonda Lynn Wilber |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629526579 PECOS PAC ID: 9739460957 Enrollment ID: I20161230001571 |
| Provider Name | Justin Deen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295027050 PECOS PAC ID: 7416176466 Enrollment ID: I20170404002330 |
| Provider Name | Todd Daniel Hewitt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962463042 PECOS PAC ID: 3779582127 Enrollment ID: I20170522001572 |
| Provider Name | Chesley Folsom Durgin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962763565 PECOS PAC ID: 6305084252 Enrollment ID: I20170804000648 |
| Provider Name | Brian James Zirgibel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780815696 PECOS PAC ID: 8224273248 Enrollment ID: I20171214002098 |
| Provider Name | Luis Felipe Pulido Sierra |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639325855 PECOS PAC ID: 9436283512 Enrollment ID: I20180308000552 |
| Provider Name | Monica Henry Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497208557 PECOS PAC ID: 6406110998 Enrollment ID: I20180509001630 |
| Provider Name | David Antonio Alvarez |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1104182708 PECOS PAC ID: 8426353434 Enrollment ID: I20180809004920 |
| Provider Name | Christopher Wade Babl |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1073660841 PECOS PAC ID: 3375778822 Enrollment ID: I20180821002512 |
| Provider Name | Ryan Christopher Price |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255685046 PECOS PAC ID: 4284873373 Enrollment ID: I20181023002991 |
| Provider Name | Garrett Craige Goodman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285275677 PECOS PAC ID: 8224462742 Enrollment ID: I20191216002481 |
| Provider Name | Kyle Summeral Mobley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952713646 PECOS PAC ID: 6002105988 Enrollment ID: I20200626000067 |
| Provider Name | Heather Michelle Whitmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740806173 PECOS PAC ID: 3476976838 Enrollment ID: I20200702001034 |
| Provider Name | Mary Kathryn Fischer |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134523392 PECOS PAC ID: 0042633976 Enrollment ID: I20200709003181 |
| Provider Name | Jordan Daniel Walters |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1720406945 PECOS PAC ID: 5890026702 Enrollment ID: I20200730001233 |
| Provider Name | Samantha Pabalan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023636008 PECOS PAC ID: 1052730645 Enrollment ID: I20201001000304 |
| Provider Name | Krystal A. Noriega |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063015725 PECOS PAC ID: 3274945357 Enrollment ID: I20201214002498 |
| Provider Name | Curtis Duggar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659961555 PECOS PAC ID: 1557775327 Enrollment ID: I20210208000700 |
| Provider Name | Brian Christopher Vogt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639407943 PECOS PAC ID: 3072920974 Enrollment ID: I20210319001577 |
| Provider Name | Selah Cheyanne Barfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699354043 PECOS PAC ID: 3274932199 Enrollment ID: I20210526001974 |
| Provider Name | Susanna Zorn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487185351 PECOS PAC ID: 0345518908 Enrollment ID: I20210709000629 |
| Provider Name | Eric Alan Branch |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1982067344 PECOS PAC ID: 1557765682 Enrollment ID: I20210811001243 |
| Provider Name | Cory A Messerschmidt |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1609161728 PECOS PAC ID: 3173812005 Enrollment ID: I20210922002953 |
| Provider Name | Bradley Walter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538131107 PECOS PAC ID: 5991919094 Enrollment ID: I20210928000345 |
| Provider Name | Tonya M Strong |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831310192 PECOS PAC ID: 4385034206 Enrollment ID: I20211208003703 |
| Provider Name | Tara Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467118836 PECOS PAC ID: 8022409044 Enrollment ID: I20211230002056 |
| Provider Name | Kourtney Gabrielle Davis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174113237 PECOS PAC ID: 5496141996 Enrollment ID: I20220411000380 |
| Provider Name | Adam Michael Almaguer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1265895676 PECOS PAC ID: 8729374715 Enrollment ID: I20220602001186 |
| Provider Name | Andrew Michael Dec |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1871851824 PECOS PAC ID: 2961720784 Enrollment ID: I20230126000082 |
| Provider Name | Currie Michelle Powers |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831631027 PECOS PAC ID: 1658655253 Enrollment ID: I20230315001257 |
| Provider Name | Cameron D Straughn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487033197 PECOS PAC ID: 8921374000 Enrollment ID: I20230717000248 |
| Provider Name | Mandy A Gibbs |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114261237 PECOS PAC ID: 5294196499 Enrollment ID: I20230804000024 |
| Provider Name | Lauren Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619657244 PECOS PAC ID: 4981066339 Enrollment ID: I20230816002766 |
| Provider Name | Amy T Phelps |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336922657 PECOS PAC ID: 9133582356 Enrollment ID: I20230905003443 |
| Provider Name | Christian Douglas Reintgen |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1760914758 PECOS PAC ID: 3870868235 Enrollment ID: I20230922003764 |
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