# ORA ORTHOPEDICS PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ORA ORTHOPEDICS PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1962481861
- **Legal business name:** ORA ORTHOPEDICS PC
- **Authorized official:** KENNETH BROCKMAN (CEO)
- **Authorized official phone:** (309) 762-3621

## Contact information

- **Practice address:** 520 VALLEY VIEW DR, MOLINE, IL 61265-6194
- **Practice address phone:** (309) 762-3621
- **Practice address fax:** (309) 762-3690
- **Mailing address:** 520 VALLEY VIEW DR, MOLINE, IL 61265-6194
- **Mailing address phone:** (309) 762-3621
- **Mailing address fax:** (309) 762-3690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WM0705X | Medical-Surgical Registered Nurse | — | NULL | — |
| 163WM0705X | Medical-Surgical Registered Nurse | — | — | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | NULL | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | — |
| 207RR0500X | Rheumatology Physician | — | NULL | — |
| 207RR0500X | Rheumatology Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | 060006850 | IL | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |
| 2084N0400X | Neurology Physician | — | — | — |
| 2084N0600X | Clinical Neurophysiology Physician | — | NULL | — |
| 2084N0600X | Clinical Neurophysiology Physician | — | — | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | NULL | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | — | — | — |
| 246ZS0410X | Surgical Technologist | — | NULL | — |
| 246ZS0410X | Surgical Technologist | — | — | — |
| 247200000X | Other Technician | — | NULL | — |
| 247200000X | Other Technician | — | — | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | NULL | — |
| 363AM0700X | Medical Physician Assistant | — | — | — |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |
| 363AS0400X | Surgical Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/10/2006
- **Last updated:** 05/20/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0073734 | — | IA |
| 01 | — | 37772 | WELLMARK | IA |
| 01 | — | 57821 | WELLMARK | IA |
| 01 | — | 58091 | WELLMARK | IA |
| 01 | — | 58104 | WELLMARK | IA |
| 01 | — | 58109 | WELLMARK | IA |
| 01 | — | 8121085 | BCBS-IL | IL |
| 01 | — | 91376 | WELLMARK | IA |
| 01 | — | 92231 | WELLMARK | IA |
| 01 | — | 99204 | WELLMARK | IA |
| 01 | — | CD9661 | RR MEDICARE | IA |
| 01 | — | CN0248 | RR MEDICARE | ID |