COMPETITIVE EDGE SPORTS MEDICINE (NPI# 1104000561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104000561 |
| Entity Type | Organization |
| Organization Name | COMPETITIVE EDGE SPORTS MEDICINE |
| Practice Address |
14160 Jamestown Rd Breese IL 62230 |
| Mailing Address |
9431 Holy Cross Ln Breese IL 62230-3510 |
| Practice Telephone | 6185262603 |
| Practice Fax Number | 6185261435 |
| Mailing Telephone | 6185262603 |
| Mailing Fax Number | 6185261435 |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2007-12-20 |
| Authorized Official Name | DR. DAVID L NEIGHBORS (PRESIDENT) |
| Authorized Official Telephone | 6185262603 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 0001400053 | 01 |
| Street Address |
14160 JAMESTOWN RD |
| City | BREESE |
| State | IL |
| Zip Code | 62230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740677533 | Hshs Medical Group Inc | Durable Medical Equipment & Medical Supplies | 14160 Jamestown Rd, Breese, IL 62230-3694 | 2015-04-20 |
| 1053662619 | Meaghan Brittany Weedon | Physical Therapist | 14160 Jamestown Rd, Breese, IL 62230-3694 | 2012-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841738457 | Coping 4 Kids | Social Worker | 900 N Walnut St., Breese, IL 62230 | 2017-02-02 |
| 1528505146 | Danielle Mueller | Licensed Practical Nurse | 604 North Chestnut, Breese, IL 62230 | 2017-01-20 |
| 1063606978 | Clarkson Optometry Illinois PC | Optometrist | 103 Clintonian Plaza, Breese, IL 62230 | 2007-09-04 |
| 1013002658 | St Josephs Hospital Breese of The Hospital Sisters of The Third Order | Family Medicine | 9401 Holy Cross Lane, Suite 112, Breese, IL 62230 | 2006-10-03 |
| 1730287434 | Breese Dental Group PC. | Dentist | 9437 Holy Cross Ln., Breese, IL 62230 | 2006-09-20 |
| 1144328832 | Joe Cao Truong | Dentist | 9437 Holy Cross Lane, Breese, IL 62230 | 2006-09-20 |
| 1356391155 | Timothy H Droege | Dentist | 111 North Main, Breese, IL 62230 | 2006-05-11 |
| 1346206042 | Thomas B Doyle | Radiology | 9515 Holy Cross Lane, Breese, IL 62230 | 2006-04-22 |
| 1346730561 | Amanda Walden | Nurse Practitioner | 9401 Holy Cross Ln Ste 112, Breese, IL 62230 | 2018-05-14 |
| 1821537820 | Talisha Nyman | Nurse Practitioner | 9401 Holy Cross Lane, Suite 112, Breese, IL 62230 | 2017-02-23 |
| Find all providers in zip 62230 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164817334 | Shachi Pandya | Family Medicine | 18350 Kedzie Ave Ste 101, Homewood, IL 60430 | 2015-04-03 |
| 1821438185 | Marianne Hana | Family Medicine | 60 Orland Square Dr Ste 101, Orland Park, IL 60462 | 2013-07-01 |
| 1376894501 | Rush-copley Medical Group | Family Medicine | 2040 Ogden Ave., Suite 304, Aurora, IL 60504 | 2012-09-27 |
| 1144495961 | Karsten B Slater | Family Medicine | 1527 College Dr, Mount Carmel, IL 62863 | 2008-04-23 |
| 1477734150 | Sashil Singh Kapur | Family Medicine | 415 N Lasalle Street, Suite 100, Chicago, IL 60654 | 2007-11-21 |
| 1659562585 | Ketan R Mody | Family Medicine | 760 Pasquinelli Dr Ste 304, Westmont, IL 60559-1290 | 2007-08-06 |
| 1285841544 | Arthur Aragones | Family Medicine | 135 E Irving Park Rd, Streamwood, IL 60107-2950 | 2007-05-17 |
| 1003028150 | Jill Wirth-rissman | Family Medicine | 205 N Cummings Ln, Washington, IL 61571-2181 | 2007-05-03 |
| 1497838676 | Christopher Eric Cieurzo | Family Medicine | 510 Pow Mia St Bldg P40, Scott Afb, IL 62225-5020 | 2006-10-23 |
| 1699861682 | Lawrence Timothy Kacmar | Family Medicine | 3965 75th St, Suite 103, Aurora, IL 60504-7925 | 2006-10-05 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COMPETITIVE EDGE SPORTS MEDICINE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.