NPIMap

Organization Active NPI

Modern Sports Medicine LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Sun Lakes, AZ
National Provider Identifier
1285295089
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
MODERN SPORTS MEDICINE LLC
Practice address
10450 E Riggs Rd Ste 104
Sun Lakes, AZ 85248-7759
Phone
(502) 415-2836
NPI assigned
Jun 24, 2019
Last updated
Aug 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Authorized official

Name
Joshua Adams
Title
Owner
Phone
(480) 306-6627

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X NU
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X NU Primary
Vascular & Interventional Radiology Physician 2085R0204X NU
Physical Therapist 225100000X NU

Addresses

Primary practice location

10450 E Riggs Rd Ste 104
Sun Lakes, AZ 85248-7759

Mailing address

10450 E Riggs Rd Ste 104
Sun Lakes, AZ 85248-7759
Phone (502) 415-2836

Other practice location 1

1840 E Warner Rd Ste 121
Tempe, AZ 85284-3445
Phone (480) 306-6627

Other practice location 2

6242 E Arbor Ave Bldg 1
Mesa, AZ 85206-1309
Phone (480) 306-6627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191120000879 AZ Part B Supplier - Clinic/Group Practice 6800228479 Receives reassigned benefits from 57 practitioners
2 other NPIs on this enrollment
Practice locations: Tucson, AZ; Surprise, AZ; Sun Lakes, AZ; Phoenix, AZ; Peoria, AZ; Mesa, AZ; Chandler, AZ; Gilbert, AZ…
O20200127000761 AZ DME Supplier - Independently-Practicing Physical TherapistDME Supplier - Sports Medicine 6800228479 Practice locations: Sun Lakes, AZ

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Azmed Lab LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

100 S McClintock Dr
Ste 100
Chandler, AZ 85226
Phone (480) 633-3388

406 N Litchfield Rd
Ste 204
Goodyear, AZ 85338
Phone (602) 995-0400

6242 E Arbor Ave
Bldg 1
Mesa, AZ 85206

6910 E Chauncey Ln
Ste 115
Phoenix, AZ 85054
Phone (480) 473-5070

2900 E Broadway Blvd
Ste 132
Tucson, AZ 85716
Phone (520) 281-2582

Practitioners & affiliated clinicians

Practitioners 62

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 62

NPI Registry JSON

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

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1285295089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10450 E RIGGS RD STE 104",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852487759",
            "telephone_number": "502-415-2836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10450 E RIGGS RD STE 104",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852487759",
            "telephone_number": "502-415-2836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 E Warner Rd Ste 121",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852843445",
            "country_code": "US",
            "telephone_number": "480-306-6627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6242 E Arbor Ave Bldg 1",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852061309",
            "country_code": "US",
            "telephone_number": "480-306-6627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MODERN SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-24",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-306-6627"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Lakes, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.