Sports Neurology Clinic

Primary specialty

Sports Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084S0010X

Legal business name

SPORTS NEUROLOGY CLINIC

Doing business as

The Sports Neurology Clinic

Practice address

8273 Grand River Rd Ste 210
Brighton, MI 48114-9346

Phone

(734) 223-4581

NPI assigned

Oct 9, 2017

Last updated

Dec 5, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Kutcher, M.D.NPI 1194806570

Title

National Director

Phone

(734) 223-4581

Specialties & licenses 3

Addresses

Other identifiers 5

Other names 1

• The Sports Neurology Clinic Doing business as

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.

• Jeffrey S Kutcher, MD

  • Neurology Physician
  • Brighton, MI
  • NPI 1194806570
  Authorized official Same address or phone

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1275043853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8273 GRAND RIVER RD STE 210",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481149346",
            "telephone_number": "810-522-6080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8273 GRAND RIVER RD STE 210",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481149346",
            "telephone_number": "734-223-4581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS NEUROLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "KUTCHER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "NATIONAL DIRECTOR",
        "authorized_official_telephone_number": "734-223-4581",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084S0010X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA DEPARTMENT OF HEALTH",
            "identifier": "ME131286",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA MEDICAL BOARD",
            "identifier": "51983",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF UTAH BOARD OF MEDICINE",
            "identifier": "8919590-1205",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN BOARD OF MEDICINE",
            "identifier": "4301073973",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOUISIANA STATE BOARD OF MEDICAL EXAMINERS",
            "identifier": "MD.203771",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Sports Neurology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hope Spaniola
• Amber Nicole Spencer
• Jodi Lynn Spiegelberg, NP
• Diane Lydia Spink, LCSW
• Sarah Lee Spivey
• Robert B Springstead, DDS
• St Joseph Mercy Behavioral Services
• Charlene Evelyn Stafford, PT
• Stand With Trans
• Alicia Anne Starbowski, MSW

• Sports Medicine (Psychiatry & Neurology) Physician in Brighton, MI
• Providers in Brighton, MI by specialty
• Sports Medicine (Psychiatry & Neurology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.