NPIMap

Organization Active NPI

Sports & Spine Pain Management, LLC

  • Medical Specialty Clinic/Center
  • Havre de Grace, MD
National Provider Identifier
1154752202
Registry record updated Apr 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
0073023 Issued in MD
Legal business name
SPORTS & SPINE PAIN MANAGEMENT, LLC
Practice address
253 Lewis LN
Suite 302
Havre de Grace, MD 21078-3750
Phone
(410) 942-0620
Fax
(410) 484-2797
NPI assigned
Nov 27, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2022

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

Authorized official

Name
Dr. Hyon K Schneider, M.D.NPI 1487814042
Title
Owner
Phone
(410) 942-0620

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 0073023 MD Primary

Addresses

Primary practice location

253 Lewis LN
Suite 302
Havre de Grace, MD 21078-3750

Mailing address

253 Lewis LN
Suite 302
Havre de Grace, MD 21078-3750
Phone (410) 942-0620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131205000142 MD Part B Supplier - Clinic/Group Practice 2860629458 Receives reassigned benefits from 5 practitioners
Practice locations: Havre de Grace, MD
O20140610001787 MD DME Supplier - Physician - Physical and Rehabilitation 2860629458 Practice locations: Havre de Grace, MD

National Provider Directory

National Provider Directory

Locations

253 Lewis Ln
Ste 302
Hvre de Grace, MD 21078
Phone (410) 942-0620

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7962/brand/1/csg/1/fhir/r4

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649030400000",
    "number": "1154752202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 LEWIS LN",
            "address_2": "SUITE 302",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783750",
            "telephone_number": "410-942-0620",
            "fax_number": "410-484-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 LEWIS LN",
            "address_2": "SUITE 302",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210783750",
            "telephone_number": "410-942-0620",
            "fax_number": "410-484-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS & SPINE PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "HYON",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-942-0620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MD",
            "license": "0073023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.