NPIMap

Organization Active NPI

Momentum Sport & Spine, PC

  • Health Service Clinic/Center
  • Fort Mill, SC
National Provider Identifier
1215824982
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
MOMENTUM SPORT & SPINE, PC
Practice address
424 Zimmer Rd
Fort Mill, SC 29707
Phone
(980) 253-6547
NPI assigned
Jun 23, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Authorized official

Name
Bradley David Wiest, DCNPI 1629395017
Title
Owner
Phone
(980) 253-6547

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
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

424 Zimmer Rd
Fort Mill, SC 29707

Mailing address

1212 Rosecliff Dr
Waxhaw, NC 28173-0162

National Provider Directory

National Provider Directory

Locations

424 Zimmer Rd
Fort Mill, SC 29707
Phone (980) 253-6547

Practitioners & affiliated clinicians

Practitioners 1

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": "1750636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750636800000",
    "number": "1215824982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 ROSECLIFF DR",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281730162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 ZIMMER RD",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29707",
            "telephone_number": "980-253-6547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM SPORT & SPINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "WIEST",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "980-253-6547",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; 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.