Sports LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2005 Issued in NV

Legal business name

SPORTS LLC

Practice address

9070 W. Cheyenne Ave
Suite. #100
Las Vegas, NV 89129

Phone

(702) 655-8535

Fax

(702) 656-5863

NPI assigned

Aug 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Stephanie Holmstrom

Title

Office Administrator

Phone

(702) 655-8535

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• FYZICAL SPORTS Doing business as

Member of 1

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

• Las Fyzical LLC

  • Physical Therapy Clinic/Center
  • Las Vegas, NV
  • NPI 1215361688

  Member Of

  NPD member

Locations

Practitioners 1

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

• Christopher Hugh Mulvey, DPT

  • Physical Therapist
  • Fort Myers, FL
  • NPI 1134193949
  NPD

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1104834050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 W. CHEYENNE AVE",
            "address_2": "STE. #100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89129",
            "telephone_number": "702-655-8535",
            "fax_number": "702-656-5863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9070 W. CHEYENNE AVE",
            "address_2": "SUITE. #100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89129",
            "telephone_number": "702-655-8535",
            "fax_number": "702-656-5863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "HOLMSTROM",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "702-655-8535",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2005",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "0449",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2004",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "V101520",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FYZICAL SPORTS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jordan Spoon, PAC
• Sydney Spoon, RD, LD
• Nerissa Spooner
• Elijah Spoozak
• Sport-Social
• Sports LLC
• Daniel Sposito
• Sara Jean Spradling
• Mercedes Spraggins
• Pamela J Spraggins

• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; 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.