SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.
NPI 1104075126
Orthopaedic Surgery in Carrondale, IL
NPI Status: Active since September 15, 2008
Contact Information
1101 DIANN LANE
CARRONDALE, IL
ZIP 62901
Phone: (618) 997-6800
Fax: (618) 457-0211
- Organization
- Orthopaedic Surgery
- CLIA Number: 14D0436414
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 04-12-2027
About SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.
This page provides the complete NPI Profile along with additional information for Southern Orthopedic Associates, S.c., a provider established in Carrondale, Illinois operating as a Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1104075126 assigned on September 2008. The practitioner's primary taxonomy code is 207X00000X with license number 042617215 (IL). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Thomas West Davis (President/orthopedic Surgeon)
- NPI
- 1104075126
- Provider Name
- SOUTHERN ORTHOPEDIC ASSOCIATES, S.C.
- Entity Type
- Organization
- Location Address
- 1101 DIANN LANE CARRONDALE, IL 62901
- Location Phone
- (618) 997-6800
- Location Fax
- (618) 457-0211
- Mailing Address
- 510 LINCOLN DRIVE HERRIN, IL 62948
- Mailing Phone
- (618) 997-6800
- Mailing Fax
- (618) 457-0211
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 09-15-2008
- Last Update Date
- 09-15-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Orthopaedic Surgery
- Taxonomy Code
- 207X00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 042617215
- License State
- IL
- Taxonomy Description
- An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D0436414
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- April 13, 2025
- Certificate Expiration Date
- April 12, 2027
- Laboratory Director
- PAMELA HUNTER-REACH
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Southern Orthopedic Associates, S.c. in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104075126, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 44. The final step is to find the difference between that total and the next multiple of ten (50 - 44 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 44 is 50. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104075126, enumerated as an "organization" on September 15, 2008.
The provider is located at 1101 DIANN LANE CARRONDALE, IL 62901 and the phone number is (618) 997-6800.
Orthopaedic Surgery with taxonomy code 207X00000X.
