NPIMap

Organization Active NPI

Med Sports Vantage PLLC

Doing business as Med Sports Vantage

  • Family Medicine Physician
  • Brighton, MI
National Provider Identifier
1326587114
Registry record updated Oct 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MED SPORTS VANTAGE PLLC
Doing business as
Med Sports Vantage
Med Sports Vantage PLLC
Practice address
210 S East St Ste 2
Brighton, MI 48116-1592
Phone
(810) 626-3036
Fax
(810) 202-1130
NPI assigned
Feb 14, 2017
Last updated
Oct 10, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2026

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

Authorized official

Name
Rachel Lethorn, PA-CNPI 1285601518
Title
Ceo / Owner
Phone
(810) 626-3036

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X 5601003608 MI
Primary Care Clinic/Center 261QP2300X NU
Physician Assistant 363A00000X 5601003608 MI
Family Medicine Physician 207Q00000X NU Primary
Addiction Medicine (Internal Medicine) Physician 207RA0401X 5601003608 MI

Addresses

Primary practice location

210 S East St Ste 2
Brighton, MI 48116-1592

Mailing address

210 S East St Ste 2
Brighton, MI 48116-1592
Phone (810) 626-3036

Other practice location 1

2900 E Grand River Ave Ste 100
Howell, MI 48843-8559
Phone (810) 626-3036

Other names 2

  • Med Sports Vantage Doing business as
  • Med Sports Vantage PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180328000385 MI Part B Supplier - Clinic/Group Practice 3476815630 Receives reassigned benefits from 3 practitioners
Practice locations: Brighton, MI

National Provider Directory

National Provider Directory

Locations

10381 Citation Dr
Ste 250
Brighton, MI 48116
Phone (810) 626-3036

210 S East St
Ste 2
Brighton, MI 48116
Phone (810) 626-3036

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791590400000",
    "number": "1326587114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S EAST ST STE 2",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161592",
            "telephone_number": "810-626-3036",
            "fax_number": "810-202-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S EAST ST STE 2",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481161592",
            "telephone_number": "810-626-3036",
            "fax_number": "810-202-1130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 E Grand River Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "MI",
            "postal_code": "488438559",
            "country_code": "US",
            "telephone_number": "810-626-3036",
            "fax_number": "810-202-1130",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MED SPORTS VANTAGE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2026-10-10",
        "certification_date": "2026-10-10",
        "status": "A",
        "authorized_official_last_name": "LETHORN",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "CEO / OWNER",
        "authorized_official_telephone_number": "810-626-3036",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MI",
            "license": "5601003608",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601003608",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "MI",
            "license": "5601003608",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Med Sports Vantage",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Sports Vantage PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Med Sports Vantage PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brighton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2026; 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.