Clemson Sports Medicine and Rehabilitation, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

CLEMSON SPORTS MEDICINE AND REHABILITATION, INC

Doing business as

Sports Plus

Practice address

108 Gateway Blvd
Suite 211-B
Mooresville, NC 28117-5596

Phone

(704) 662-0386

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Debbie Baxter

Title

Credentialing

Phone

(864) 482-0064

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sports Plus Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eugene J Collins, MPT

  • Physical Therapist
  • Mooresville, NC
  • NPI 1245368687
  NPD (past)
• Marla Little Faulkenberry, LPTA

  • Physical Therapy Assistant
  • Mooresville, NC
  • NPI 1528259611
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301270400000",
    "number": "1306945357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1844",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296331844",
            "telephone_number": "864-482-0064",
            "fax_number": "864-482-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 GATEWAY BLVD",
            "address_2": "SUITE 211-B",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281175596",
            "telephone_number": "704-662-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEMSON SPORTS MEDICINE AND REHABILITATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2011-03-28",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "864-482-0064"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212045",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sports Plus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Skylar Clark, LCMHCA
• Anna Louise Claugus, MD
• Alyssa Danielle Clay Bartosz, DNP, FNP-C
• Kendall Clay
• Janice Maureen Clayton, NP
• Kristin Marie Clewell, OTR L
• Julie Clifford
• Ashley Nicole Cline, MS, OTR/L
• Kathryn Randolph Cluderay, PHARMD, RPH
• Rachelle Cluff

• Physical Therapy Clinic/Center in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Physical Therapy Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; 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.