MODERN SPORTS MEDICINE LLC (NPI# 1568072387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1568072387 |
Entity Type | Organization |
Organization Name | MODERN SPORTS MEDICINE LLC |
Practice Address |
1840 E Warner Rd Ste 121 Tempe AZ 85284-3445 |
Practice Telephone | 4808784806 |
Practice Fax Number | 4808401672 |
Mailing Telephone | 4808784806 |
Mailing Fax Number | 4808401672 |
Enumeration Date | 2020-08-06 |
Last Update Date | 2020-08-06 |
Authorized Official Name | MRS. HALEIGH SHEREE MERSHON (DIRECTOR OF REVENUE) |
Authorized Official Telephone | 4808784806 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 2251S0007X |
Physical Therapist Specialization: Sports |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
N | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942810833 | Modern Sports Medicine LLC | Specialist | 6242 E Arbor Ave Unit 1, Mesa, AZ 85206-1309 | 2020-08-05 |
1285295089 | Modern Sports Medicine LLC | Family Medicine | 10450 E Riggs Rd Ste 104, Sun Lakes, AZ 85248-7759 | 2019-06-24 |
1700495892 | Modern Sports Medicine LLC | Preventive Medicine | 14821 N Del Webb Blvd, Sun City, AZ 85351-2145 | 2020-07-24 |
Street Address |
1840 E WARNER RD STE 121 |
City | TEMPE |
State | AZ |
Zip Code | 85284-3445 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275187726 | Satbir Khara | Dentist | 2010 E. Elliot Rd. Suite 105, Tempe, AZ 85284 | 2019-08-01 |
1093287187 | Tawnie C Caracci | Registered Nurse | 1437 W. Auto Drive, Tempe, AZ 85284 | 2018-12-30 |
1932695947 | Angels of Mercy Attendant Care LLC | In Home Supportive Care | 130 W Freda Rd, Tempe, AZ 85284 | 2018-07-03 |
1487169009 | Restorative Healing and Counseling Center LLC | Clinic/Center | 9855 S. Priest Drive, Suite 102, Tempe, AZ 85284 | 2017-12-05 |
1366964934 | Devoted Guardians Home Health LLC | Home Health | 1705 West Ruby Drive, #107, Tempe, AZ 85284 | 2017-07-14 |
1982134565 | Otilia Elizabeth Herrera Jaimes | Specialist/Technologist | 315 W. Elliot Road #107-250, Tempe, AZ 85284 | 2017-06-15 |
1982142873 | Tempe Outpatient Treatment Center LLC | Clinic/Center | 1001 E Warner Rd Ste 103, Tempe, AZ 85284 | 2017-02-10 |
1386180560 | Jenna Bernal | Registered Nurse | 931 E Elliot Rd Ste 115, Tempe, AZ 85284 | 2017-01-12 |
1780084533 | Mirvat Farah | Specialist/Technologist | 341 W El Freda Rd, Tempe, AZ 85284 | 2014-08-29 |
1245661503 | Janine L Roberts | Registered Nurse | 2033 E Warner Rd #109, Tempe, AZ 85284 | 2013-12-11 |
Find all providers in zip 85284 |
Taxonomy Code | 2081S0010X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Physical Medicine & Rehabilitation |
Specialization | Sports Medicine |
A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689805194 | Southwest Spine and Sports | Physical Medicine & Rehabilitation | 1025 E Broadway Rd, Suite 201, Tempe, AZ 85282-1599 | 2009-07-31 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689233785 | Tara Anne Condon | Physical Medicine & Rehabilitation | 3300 W Camelback Rd Bldg 12, Phoenix, AZ 85017-3030 | 2019-06-12 |
1528556495 | Stone Med, LLC | Physical Medicine & Rehabilitation | 77 S Dobson Rd., Phoenix, AZ 85224 | 2018-04-26 |
1801390885 | Melissa Abellanida | Physical Medicine & Rehabilitation | 9127 W Thunderbird Rd Ste 101, Peoria, AZ 85381-4887 | 2018-03-22 |
1386173748 | Aliesje Nichole Thrower | Physical Medicine & Rehabilitation | 8465 E Hodgman Pl, Tucson, AZ 85747 | 2017-06-08 |
1194167858 | Rejuv Medical Southwest Corp | Physical Medicine & Rehabilitation | 7790 N Oracle Rd, Suite 150, Tucson, AZ 85704-6579 | 2013-07-23 |
1366622466 | Jonathan David Tait | Physical Medicine & Rehabilitation | 7790 N Oracle Rd Ste 150, Suite 150, Oro Valley, AZ 85704-6589 | 2007-11-06 |
1245455666 | David Iannicca | Physical Medicine & Rehabilitation | 15946 N Bullard Ave, Surprise, AZ 85374-8844 | 2007-04-13 |
1659402998 | East Valley Spine and Sports Medicine Center, Plc | Physical Medicine & Rehabilitation | 4858 E Baseline Rd, Suite 107, Mesa, AZ 85206-4638 | 2007-03-08 |
1821141250 | Sholom Gootzeit | Physical Medicine & Rehabilitation | 17233 N Holmes Blvd Ste 1640, 13761 W. Bell Road, Suite 203, Surprise, Az 85374, Phoenix, AZ 85053-2020 | 2007-01-19 |
1497728372 | Michael G. Crincoli | Physical Medicine & Rehabilitation | 1012 East Willetta Street, Phoenix, AZ 85006 | 2006-02-09 |
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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.