Sports Medicine North Orthopaedic Surgery, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY, INC

Practice address

147 S Main St
Middleton, MA 01949-2446

Phone

(978) 818-6350

Fax

(978) 818-6355

NPI assigned

Sep 14, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey A Polansky, MD

Title

President

Phone

(978) 818-6350

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365638400000",
    "number": "1053693200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ORTHOPEDICS DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601668",
            "telephone_number": "978-818-6350",
            "fax_number": "978-818-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 S MAIN ST",
            "city": "MIDDLETON",
            "state": "MA",
            "postal_code": "019492446",
            "telephone_number": "978-818-6350",
            "fax_number": "978-818-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-14",
        "last_updated": "2013-04-11",
        "status": "A",
        "authorized_official_last_name": "POLANSKY",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-818-6350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "M15814",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9773363",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Haitham Serhan, NP-C
• Brian Silva, BS
• Brittany S Smith
• Erin E Smith, PHARMD
• Samantha Spagnuolo, LMHC
• Sports Rehabilitation Unlimited, LLC
• Sportsfit Physical Therapy, LLC
• Spring Valley Behavioral Consultants LLC
• Standard Medical Group LLC
• Kelli Ann Sullivan, LICSW

• Specialist in Middleton, MA
• Providers in Middleton, MA by specialty
• Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2013; 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.