NPIMap

Organization Active NPI

Lags Spine and Sportscare Medical Centers, Inc.

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Modesto, CA
National Provider Identifier
1265906499
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X
Legal business name
LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.
Practice address
1317 Oakdale Rd Ste 800
Modesto, CA 95355-3366
Phone
(209) 284-0729
Fax
(209) 342-6634
NPI assigned
Jan 22, 2019
Last updated
Jan 22, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Authorized official

Name
Amy D'Amato
Title
Contracts Manager
Phone
(805) 264-3388

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X NU
Clinical Social Worker 1041C0700X NU
Psychiatric/Mental Health Registered Nurse 163WP0808X NU
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X NU Primary

Addresses

Primary practice location

1317 Oakdale Rd Ste 800
Modesto, CA 95355-3366

Mailing address

218 N I St
Lompoc, CA 93436-0909
Phone (805) 736-7886

National Provider Directory

National Provider Directory
Tax ID family
Lags Spine and Sportscare Medical Centers Inc52 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1317 Oakdale Rd
Ste 800
Modesto, CA 95355
Phone (209) 284-0729

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1265906499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 N I ST",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934360909",
            "telephone_number": "805-736-7886",
            "fax_number": "805-736-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 OAKDALE RD STE 800",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553366",
            "telephone_number": "209-284-0729",
            "fax_number": "209-342-6634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGS SPINE AND SPORTSCARE MEDICAL CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "D'AMATO",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CONTRACTS MANAGER",
        "authorized_official_telephone_number": "805-264-3388"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.