THE SPORTS & SPINE CENTER PC (NPI# 1649604075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649604075 |
| Entity Type | Organization |
| Organization Name | THE SPORTS & SPINE CENTER PC |
| Practice Address |
19824 Sw 72nd Ave 101 Tualatin OR 97062-8397 |
| Practice Telephone | 5036912000 |
| Practice Fax Number | 5036912001 |
| Mailing Telephone | 5036912000 |
| Mailing Fax Number | 5036912001 |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2014-03-11 |
| Authorized Official Name | JIMMY D HUEBERT (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 5036912000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RS0010X |
Internal Medicine Specialization: Sports Medicine |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | THE SPORTS & SPINE CENTER PC | 19824 Sw 72nd Ave #101, Tualatin, OR 97062 |
| Street Address |
19824 SW 72ND AVE 101 |
| City | TUALATIN |
| State | OR |
| Zip Code | 97062-8397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225050834 | Jimmy Dee Huebert | Internal Medicine | 19824 Sw 72nd Ave, Suite 101, Tualatin, OR 97062-8397 | 2006-07-24 |
| 1790234730 | Annmarie Johnson Counseling LLC | Counselor | 19824 Sw 72nd Ave, Tualatin, OR 97062-8397 | 2016-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467018739 | Activeedge Tualatin, LLP | Physical Therapist | 19150 Sw 90th Avenue, Suite 200, West Linn, OR 97062 | 2019-05-13 |
| 1932607934 | Naturalways Pediatrics | Clinic/Center | 18813 Sw Martiazzi Ave, Tualatin, OR 97062 | 2018-01-25 |
| 1831646280 | Elizabeth Erin Tafesse | Behavioral Analyst | 18765 Sw Boones Ferry Rd Suite 100, Tualatin, OR 97062 | 2016-09-01 |
| 1962851311 | Ana Mercedes Cerritos-sanchez | Community Health Worker | 19355 Sw 65th Ave Apt A5, Tualatin, OR 97062 | 2016-06-07 |
| 1952759318 | William Luke Summers | Counselor | 18840 Southwest Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2016-05-26 |
| 1730536913 | Krystle Alligood | Behavioral Analyst | 18768 Sw Boones Ferry Road, Tualatin, OR 97062 | 2016-05-18 |
| 1760869739 | Oregon City Medical Nw, Inc | Clinic/Center | 6464 Sw Borland Road #d-4, Tualatin, OR 97062 | 2015-04-29 |
| 1396148904 | Tracy Filley | Clinical Nurse Specialist | 18840 Sw Boones Ferry Rd, Suite 208, Tualatin, OR 97062 | 2014-09-28 |
| 1043646474 | Michelle Lords | Registered Nurse | 7668 Sw Mohawk Street, Tualatin, OR 97062 | 2013-09-17 |
| 1871930750 | Sharon Ruth Frank | Social Worker | 7668 Sw Mohawk St., Aps Healthcare, Tualatin, OR 97062 | 2013-05-31 |
| Find all providers in zip 97062 | ||||
| Taxonomy Code | 207RS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Sports Medicine |
| An internist 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 healthcare of the individual. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235307331 | Jimmy Huebert Md Inc | Internal Medicine | 6464 Sw Borland Rd Ste D2, Tualatin, OR 97062-8861 | 2008-02-12 |
| 1225050834 | Jimmy Dee Huebert | Internal Medicine | 19824 Sw 72nd Ave, Suite 101, Tualatin, OR 97062-8397 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326688995 | Carol L Otis | Internal Medicine | 0836 Sw Curry St Unit 1400, Portland, OR 97239-4529 | 2020-01-13 |
| 1932615507 | Sonrisa Alison Street | Internal Medicine | 16315 Sw Barrows Rd Ste 203a, Beaverton, OR 97007-9461 | 2017-12-19 |
| 1447705801 | Pursuit Sports Medicine, LLC | Internal Medicine | 2222 Nw Lovejoy St, Ste 522, Portland, OR 97210-3033 | 2016-08-16 |
| 1689785925 | Paul W Johnson | Internal Medicine | 2222 Nw Lovejoy St, Ste 522, Portland, OR 97210-3033 | 2006-08-31 |
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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.