NPIMap

Organization Active NPI

Sports Medicine Associates of San Antonio, PA

  • Sports Medicine (Family Medicine) Physician
  • San Antonio, TX
National Provider Identifier
1306674981
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, PA
Practice address
430 W Sunset Rd Ste 440
San Antonio, TX 78209-1770
Phone
(210) 699-8326
NPI assigned
Jul 24, 2024
Last updated
Sep 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
Julie Birkelo
Title
Credentialing Specialist
Phone
(210) 756-5240

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Physician Assistant 363A00000X
Family Nurse Practitioner 363LF0000X
Sports Medicine (Family Medicine) Physician 207QS0010X Primary
Orthopaedic Surgery Physician 207X00000X
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X
Physical Medicine & Rehabilitation Physician 208100000X
Foot & Ankle Surgery Podiatrist 213ES0103X

Addresses

Primary practice location

430 W Sunset Rd Ste 440
San Antonio, TX 78209-1770

Mailing address

21 Spurs LN Ste 300
San Antonio, TX 78240-1679
Phone (210) 756-5240

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1306674981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SPURS LN STE 300",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401679",
            "telephone_number": "210-756-5240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 W SUNSET RD STE 440",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782091770",
            "telephone_number": "210-699-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE ASSOCIATES OF SAN ANTONIO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "BIRKELO",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "210-756-5240"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.