OrganizationActive
Community Orthopedics & Sports Medicine, PC
NPI 1710261623 · Orthopaedic Surgery Physician · Sparta, IL
Provider details
- NPI number
- 1710261623
- Entity type
- Organization
- Primary specialty
- Orthopaedic Surgery PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Community Orthopedics & Sports Medicine, PC
- Organization subpart
- Yes
- Authorized official
- Tammy Adderley, Credentialing(314) 432-2580
- License
- 036109093 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(81/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
818 E Broadway St
1st Floor
Sparta, IL 62286-1820
Phone: (618) 443-2177
Fax: (618) 443-1324
Street-level locationGet directions
Mailing address
Po Box 1449
Maryland Heights, MO 63043-0449
Registry dates
- Enumerated
- 2011-10-11
- Last updated
- 2011-10-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.