NPIMap

Organization Active NPI

Sports Medicine Institute - Los Angeles a Prof Physical Therapy Co

  • Physical Therapist
  • Los Angeles, CA
National Provider Identifier
1093713125
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORTS MEDICINE INSTITUTE - LOS ANGELES A PROF PHYSICAL THERAPY CO
Practice address
9100 S Sepulveda Blvd
Ste 116
Los Angeles, CA 90045-4814
Phone
(714) 939-6200
Fax
(714) 939-6500
NPI assigned
Jul 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Authorized official

Name
Cindy Graham, PT
Title
Manager
Phone
(714) 939-6200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

9100 S Sepulveda Blvd
Ste 116
Los Angeles, CA 90045-4814

Mailing address

1590 S Sinclair St
C/O Smi
Anaheim, CA 92806-5933
Phone (714) 939-6200

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

9100 S Sepulveda Blvd
Ste 116
Los Angeles, CA 90045
Phone (310) 649-6470

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1093713125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 S SINCLAIR ST",
            "address_2": "C/O SMI",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928065933",
            "telephone_number": "714-939-6200",
            "fax_number": "714-939-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 S SEPULVEDA BLVD",
            "address_2": "STE 116",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900454814",
            "telephone_number": "714-939-6200",
            "fax_number": "714-939-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE INSTITUTE - LOS ANGELES A PROF PHYSICAL THERAPY CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "CINDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "714-939-6200",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.