Mid State Orthopaedic & Sports Medicine Center, LLC
NPI 1104890052ActiveOrganization· Orthopaedic Surgery· Alexandria, LA
Orthopaedic Surgery in Alexandria, Louisiana, registered in NPPES in February 2006. The authorized official on file is Nakita C. Hickman, Credentialing Manager. Enrolled in Medicare as dme supplier - physician - orthopedic/orthopedic surgery and part b supplier - clinic/group practice.
Overview
| NPI | 1104890052 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 16, 2006 |
| Last updated in NPPES | Mar 24, 2026 |
| Certified by provider | Mar 24, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Orthopaedic Surgery Primary | 207X00000X | — | — |
| Physical Medicine & Rehabilitation | 208100000X | — | — |
| Physical Therapist | 225100000X | — | — |
| Occupational Therapist | 225X00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Orthopedic/Orthopedic Surgery (LA); Part B Supplier - Clinic/Group Practice (LA) |
|---|
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