NPIMap

Organization Active NPI

Sarasota Spine & Sport Chiropractic Clinic

  • Sports Medicine (Internal Medicine) Physician
  • Sarasota, FL
National Provider Identifier
1174861165
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
Legal business name
SARASOTA SPINE & SPORT CHIROPRACTIC CLINIC
Practice address
3900 Clark Rd
H-1
Sarasota, FL 34233-2301
Phone
(941) 926-1600
Fax
(941) 926-1166
NPI assigned
Jan 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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

Authorized official

Name
Dr. Jonathan Alan Berman, DC
Title
Owner
Phone
(941) 926-1600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0010X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

3900 Clark Rd
H-1
Sarasota, FL 34233-2301

Mailing address

3900 Clark Rd
H-1
Sarasota, FL 34233-2301
Phone (941) 926-1600

Other identifiers 3

IdentifierTypeStateIssuer
7276950001OtherFLDME
DU2456OtherFLRR MEDICARE
HA944AOtherFLMEDICARE

Other names 1

  • Sarasota Spine & Joint Integrated Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130401000109 FL Part B Supplier - Clinic/Group Practice 8426293127 Receives reassigned benefits from 10 practitioners
Practice locations: Sarasota, FL
O20150224001110 FL DME Supplier - Physician - General Practice 8426293127 Practice locations: Sarasota, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1359072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523232000000",
    "number": "1174861165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 CLARK RD",
            "address_2": "H-1",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332301",
            "telephone_number": "941-926-1600",
            "fax_number": "941-926-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 CLARK RD",
            "address_2": "H-1",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332301",
            "telephone_number": "941-926-1600",
            "fax_number": "941-926-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SARASOTA SPINE & SPORT CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-25",
        "last_updated": "2018-04-09",
        "status": "A",
        "authorized_official_last_name": "BERMAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-926-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "7276950001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DU2456",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "HA944A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sarasota Spine & Joint Integrated Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.