SIDELINE ORTHOPEDICS AND SPORTS MEDICINE, LLC (NPI# 1932638921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932638921 |
| Entity Type | Organization |
| Organization Name | SIDELINE ORTHOPEDICS AND SPORTS MEDICINE, LLC |
| Practice Address |
1787 W. Lee Hwy Forest Medical Park, Unit B, Bldg 2 Wytheville VA 24382-1437 |
| Mailing Address |
Po Box 823948 Philadelphia PA 19182-3948 |
| Practice Telephone | 5404427133 |
| Practice Fax Number | 5405527143 |
| Mailing Telephone | 5403453556 |
| Mailing Fax Number | 5403422193 |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2019-07-08 |
| Authorized Official Name | BART L EASTWOOD (PRESIDENT) |
| Authorized Official Telephone | 5403453556 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
0102204066 | VA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831751148 | Sideline Orthopedics and Sports Medicine, LLC | Orthopaedic Surgery | 125 Akers Farm Rd Ste C&d, Christiansburg, VA 24073-4866 | 2019-07-08 |
| 1649753500 | Sideline Orthopedics and Sports Medicine, LLC | Orthopaedic Surgery | 111e Sanders Ln, Bluefield, VA 24605-9278 | 2018-09-07 |
| 1841649068 | Sideline Orthopedics and Sports Medicine, LLC | Orthopaedic Surgery | 250 S Main St, Suite 224a, Blacksburg, VA 24060 | 2016-06-08 |
| Street Address |
1787 W. LEE HWY FOREST MEDICAL PARK, UNIT B, BLDG 2 |
| City | WYTHEVILLE |
| State | VA |
| Zip Code | 24382-1437 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538709118 | Pt Solutions LLC | Physical Therapist | 1050 Holston Road, Wytheville, VA 24382 | 2020-01-10 |
| 1881233377 | Amie S Newberry | Physical Therapist | 1050 Holston Rd, Wytheville, VA 24382 | 2019-12-31 |
| 1174160618 | Erin Leigh Dejesus | Family Medicine | 375 W Ridge Rd, Wytheville, VA 24382 | 2019-12-03 |
| 1629639497 | Family Preservatrion Services, Inc. | Community/Behavioral Health | 425 Grayson Presbyterian Road, Wytheville, VA 24382 | 2019-06-24 |
| 1023527926 | Emily Kingrey | Occupational Therapist | 800 E Main St., Suite 310, Wytheville, VA 24382 | 2017-09-22 |
| 1184149247 | Linda Huber | Driver | 610 E Washington St, Wytheville, VA 24382 | 2017-08-10 |
| 1578987558 | Family Preservation Services, Inc | Community/Behavioral Health | 695 East Marshall Street, Wytheville, VA 24382 | 2014-02-11 |
| 1255774121 | Forest Pharmacy Inc | Pharmacy | 1787 W Lee Highway, Suite B, Wytheville, VA 24382 | 2013-04-10 |
| 1447500400 | Guardian Pharmacy of Virginia LLC | Pharmacy | 860 Stafford Umberger Dr, Wytheville, VA 24382 | 2012-09-17 |
| 1669604385 | Catherine Elizabeth Russell | Physical Therapist | 710 West Ridge Rd, Suites E & F, Wytheville, VA 24382 | 2009-08-13 |
| Find all providers in zip 24382 | ||||
| Taxonomy Code | 207XX0005X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Sports Medicine |
| An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831751148 | Sideline Orthopedics and Sports Medicine, LLC | Orthopaedic Surgery | 125 Akers Farm Rd Ste C&d, Christiansburg, VA 24073-4866 | 2019-07-08 |
| 1881171718 | Franklin Clinic Corp | Orthopaedic Surgery | 210 Fairview Dr Ste A, Franklin, VA 23851-1216 | 2018-07-24 |
| 1477956878 | Virginia Commonwealth University | Orthopaedic Surgery | 821 W Franklin St, Richmond, VA 23284-9012 | 2014-09-30 |
| 1871920132 | Mark T Wolfe | Orthopaedic Surgery | 3906 Breezeport Way, Apt 105, Suffolk, VA 23435-1080 | 2013-10-02 |
| 1750724167 | Ryan Austin Harrell | Orthopaedic Surgery | 5818 Harbour View Blvd Ste 150d, Suffolk, VA 23435-3327 | 2013-04-16 |
| 1306088687 | Nathan William Coleman | Orthopaedic Surgery | 13350 Franklin Farm Rd Ste 220, Herndon, VA 20171-4095 | 2009-04-01 |
| 1497923288 | Ryan Glenn Miyamoto | Orthopaedic Surgery | 3620 Joseph Siewick Dr Ste 201, Fairfax, VA 22033-1758 | 2008-02-14 |
| 1467662791 | Stephen F. Brockmeier | Orthopaedic Surgery | 515 Ray C Hunt Dr Ste 1100, Charlottesville, VA 22903-2981 | 2007-05-23 |
| 1386706620 | David R. Diduch | Orthopaedic Surgery | 515 Ray C. Hunt Dr, Charlottesville, VA 22903-2981 | 2006-12-14 |
| 1821065848 | Mark D. Miller | Orthopaedic Surgery | 400 Ray C Hunt Dr, Suite 330, Charlottesville, VA 22903-2980 | 2006-03-08 |
| Find all providers with the same taxonomy | ||||
| City | WYTHEVILLE |
| Zip Code | 24382 |
Please comment or provide details below to improve the information on SIDELINE ORTHOPEDICS AND SPORTS MEDICINE, LLC.
| 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.