NPIMap

Organization Active NPI

Orthosports1St PC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Madison, AL
National Provider Identifier
1184438855
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
Legal business name
ORTHOSPORTS1ST PC
Practice address
5510 Promenade Point Pkwy NW # 160
Madison, AL 35758-6702
Phone
(256) 289-8470
Fax
(256) 993-3096
NPI assigned
Feb 4, 2025
Last updated
Apr 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ORTHOSPORTS1ST PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Authorized official

Name
Mr. Mark Covin
Title
Administrator
Phone
(205) 352-2911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X NU Primary

Addresses

Primary practice location

5510 Promenade Point Pkwy NW # 160
Madison, AL 35758-6702

Mailing address

PO Box 830525
Department# Owc 24
Birmingham, AL 35283-0525
Phone (205) 352-2911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250510000145 AL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 8729402037 Practice locations: Madison, AL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Orthosports1St PC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1184438855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 830525",
            "address_2": "DEPARTMENT# OWC 24",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352830525",
            "telephone_number": "205-352-2911",
            "fax_number": "205-352-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 PROMENADE POINT PKWY NW # 160",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357586702",
            "telephone_number": "256-289-8470",
            "fax_number": "256-993-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOSPORTS1ST PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORTHOSPORTS1ST PC",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "COVIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "205-352-2911",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.