SPORTS MEDICINE GROUP (NPI# 1629177225) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629177225 |
| Entity Type | Organization |
| Organization Name | SPORTS MEDICINE GROUP |
| Other Organization Name | THE SPORTS MEDICINE CLINIC |
| Practice Address |
10330 Meridian Ave N Suite 300 Seattle WA 98133-9451 |
| Practice Telephone | 2063686100 |
| Practice Fax Number | 2063686101 |
| Mailing Telephone | 2063686100 |
| Mailing Fax Number | 2063686101 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2008-09-25 |
| Authorized Official Name | RICKI VADSET (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 2063686100 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHWEST HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
601 664 888 | WA | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| The Sports Medicine Clinic | Doing Business As Name - Organization |
| Street Address |
10330 MERIDIAN AVE N SUITE 300 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98133-9451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568467439 | Lisa A Conaghan | Obstetrics & Gynecology | 10330 Meridian Ave N, Ste 300, Seattle, WA 98133-9463 | 2005-06-16 |
| 1568095347 | Erin Shaw | Physical Therapy Assistant | 10330 Meridian Ave N, Seattle, WA 98133-9451 | 2020-02-19 |
| 1427544329 | Victoria Swarthout | Advanced Practice Midwife | 10330 Meridian Ave N, Seattle, WA 98133-9451 | 2018-07-03 |
| 1932607942 | David John Reinhart | Physical Therapist | 10330 Meridian Ave N, Seattle, WA 98133-9451 | 2018-01-24 |
| 1013462597 | Jessica Lynne Holloway | Physical Therapist | 10330 Meridian Ave N, Seattle, WA 98133-9451 | 2016-08-24 |
| 1578910527 | Dustin William Butler | Physical Therapist | 10330 Meridian Ave N, Ste. 380, Seattle, WA 98133-9451 | 2016-05-19 |
| 1225403777 | Sally Jane Manion | Registered Nurse | 10330 Meridian Ave N, Suite 190, Seattle, WA 98133-9451 | 2015-12-09 |
| 1245614577 | Janell Christianson | Registered Nurse | 10330 Meridian Ave N, Suite 300, Seattle, WA 98133-9451 | 2015-07-16 |
| 1205259462 | Joy Schuler | Registered Nurse | 10330 Meridian Ave N, Suite 300, Seattle, WA 98133-9451 | 2014-01-23 |
| 1700216215 | Lynsey Barker | Registered Nurse | 10330 Meridian Ave N, Suite 300, Seattle, WA 98133-9451 | 2013-11-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891339388 | Marni Lynn Hanig | Occupational Therapist | 1900 N 170th St., Shoreline, WA 98133 | 2019-10-29 |
| 1871074807 | Minju Kim | Counselor | 14332 Burke Ave N, Seattle, WA 98133 | 2018-08-27 |
| 1821582941 | Hana Alema Misgina | Registered Nurse | 927 N 199th St, Shoreline, WA 98133 | 2018-06-21 |
| 1588177729 | Julie Benefiel | Pharmacist | 1536 N 115th St. Suite 100, Seattle, WA 98133 | 2017-11-09 |
| 1730607953 | Aurora Oaks, LLC | Skilled Nursing Facility | 16357 Aurora Avenue North, Shoreline, WA 98133 | 2017-09-08 |
| 1750801072 | Zoe Ana Cavnar-lewandowski | Counselor | 10700 Meridian Avenue N, Suite G-11, Seattle, WA 98133 | 2017-06-27 |
| 1851820211 | Adam Lee Gardner Sr. | Acupuncturist | 925 N 163rd Street, Unit B, Shoreline, WA 98133 | 2017-06-08 |
| 1376085209 | Pamela Ashby | Counselor | 2111 N. Northgateway, 212, Seattle, WA 98133 | 2016-11-09 |
| 1225584956 | General Dentistry | Dentist | 20109 Aurora Ave N, Ste D, Shoreline, WA 98133 | 2016-09-01 |
| 1144672668 | Aaron Neubauer | Behavioral Analyst | 13407 Greenwood Ave N, 216c, Seattle, WA 98133 | 2016-07-08 |
| Find all providers in zip 98133 | ||||
| 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 |
|---|---|---|---|---|
| 1649211764 | Mark David Wagner | Family Medicine | 1000 Dexter Ave N Ste 320, Seattle, WA 98109-4878 | 2006-06-09 |
| 1497173991 | Ashley Austin | Family Medicine | 1959 Ne Pacific St, Seattle, WA 98195-0816 | 2014-04-01 |
| 1871859942 | Brian Kenneth Snitily | Family Medicine | 601 Broadway Fl 6, Seattle, WA 98122-5330 | 2012-04-03 |
| 1316142862 | Emily L Cooper | Family Medicine | 400 N 34th St, 300, Seattle, WA 98103-8600 | 2007-06-15 |
| 1063563229 | Maxine J. Weyant | Family Medicine | 901 Boren Ave, Suite 900, Seattle, WA 98104-3595 | 2007-01-15 |
| 1659487056 | Jordan S D Y Chun | Family Medicine | 1100 9th Ave, Seattle, WA 98101-2756 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326565110 | Family Care Network, Pllc | Family Medicine | 3130 Squalicum Pkwy Ste 110, Bellingham, WA 98225-1940 | 2017-08-23 |
| 1578682100 | Robert Stewart Nicol | Family Medicine | 23512 Ne 206th St, Battle Ground, WA 98604-9699 | 2007-03-28 |
| 1912033663 | Richard Terril Jacobs | Family Medicine | 1351 Fowler St, Richland, WA 99352-4714 | 2007-02-26 |
| 1821132481 | James E Hult | Family Medicine | 800 N 5th Ave # 101, Sequim, WA 98382-3045 | 2007-02-16 |
| 1598874430 | Patrick Z Pearce | Family Medicine | 730 N Hamilton St, Spokane, WA 99202-2045 | 2006-08-30 |
| 1265450514 | Lawrence J Greenblatt X | Family Medicine | 1407 116th Ave Ne Ste 102, Bellevue, WA 98004-3819 | 2006-07-17 |
| 1528015229 | Public Hospital District #1 of King County | Family Medicine | 3600 Lind Ave Sw, Suite 170, Renton, WA 98055-4934 | 2006-05-28 |
| 1063486074 | Warren Billings Howe | Family Medicine | 516 High St, Wwu Student Health (ms-9132), Bellingham, WA 98225-5946 | 2006-02-15 |
| 1588280804 | Rainier Family and Sports Medicine P C | Family Medicine | 16202 64th St E Ste 104, Sumner, WA 98390-3028 | 2020-06-23 |
| 1417469404 | Maksportsmd | Family Medicine | 19110 Bothell Way Ne Ste 102, Bothell, WA 98011-2970 | 2017-10-30 |
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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.