MODERN SPORTS MEDICINE LLC


Address: 1840 E Warner Rd Ste 121, Tempe, AZ 85284-3445
Phone: 4808784806

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).

Provider Overview

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

Taxonomy

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

Other Provider IDs and Locations

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

Office Location

Street Address 1840 E WARNER RD STE 121
City TEMPE
State AZ
Zip Code 85284-3445

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2081S0010X
Grouping Allopathic & Osteopathic Physicians
Classification Physical Medicine & Rehabilitation
Specialization Sports Medicine

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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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Competitor

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City TEMPE
Zip Code 85284

Improve Information

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Dataset Information

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.

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