Sporterdo LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

288579 1204 Issued in UT

Legal business name

SPORTERDO LLC

Doing business as

Ingegrative Medical Assicates

Practice address

3650 N University Ave
Suite 200
Provo, UT 84604-6656

Phone

(801) 375-7100

Fax

(801) 375-7102

NPI assigned

Oct 22, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Stuart Porter, D.O.

Title

Physician

Phone

(801) 375-7100

Specialties & licenses 1

Addresses

Other names 1

• Ingegrative Medical Assicates Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joshua D Arnold, PAC

  • Physician Assistant
  • Orem, UT
  • NPI 1053532432
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1023344272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 N UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046656",
            "telephone_number": "801-375-7100",
            "fax_number": "801-375-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 N UNIVERSITY AVE",
            "address_2": "SUITE 200",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046656",
            "telephone_number": "801-375-7100",
            "fax_number": "801-375-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTERDO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-22",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "801-375-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "288579 1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ingegrative Medical Assicates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Black Sperry, M.D.
• Michelle Spilker, RD
• Spinal Interventions, PLLC
• Spine Craft Utah LLC
• Spine Orthopedic & Sports Physical Therapy LLC
• Elizabeth Ann Spresser
• Elizabeth Renee Springfield
• Squire Counseling
• Squire Counseling
• Jasmeen Sran

• Family Medicine Physician in Provo, UT
• Providers in Provo, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.