Sport Life Physical Therapy LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

Legal business name

SPORT LIFE PHYSICAL THERAPY LLC

Practice address

21 Vine St
Holliston, MA 01746-2311

Phone

(508) 577-2279

NPI assigned

Nov 2, 2020

Organization subpart

No

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

Authorized official

Name

Nathaniel McMahan, MSPTNPI 1801046073

Title

Owner

Phone

(508) 577-2279

Specialties & licenses 1

Addresses

Practitioners 1

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

• Nathaniel McMahan

  • Physical Therapist
  • Medway, MA
  • NPI 1801046073
  NPD Authorized official

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1104427665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 VINE ST",
            "city": "HOLLISTON",
            "state": "MA",
            "postal_code": "017462311",
            "telephone_number": "508-577-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 VINE ST",
            "city": "HOLLISTON",
            "state": "MA",
            "postal_code": "017462311",
            "telephone_number": "508-577-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT LIFE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "MCMAHAN",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-577-2279",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lwigh Schmitt, LMHC
• Nancy M Sibley, P.T.
• Mohammad M Siddiqui, MD
• Emma Smith, BCBA
• Suzanne Smith, RN
• Sport Station Adapted Exercises Corp
• Alisha Stadnicki, DPT
• Rosa Stalzer
• Stephanie Davidoff, M.D., PH.D., LLC
• Steven E Katz D.C., P.a.

• Orthopedic Physical Therapist in Holliston, MA
• Providers in Holliston, MA by specialty
• Orthopedic Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.