Sport & Spine Clinic LP

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

SPORT & SPINE CLINIC LP

Practice address

4107 Barbican Ave
Suite 260
Weston, WI 54476-4143

Phone

(715) 359-8465

Fax

(715) 359-8832

NPI assigned

Jul 1, 2006

Organization subpart

No

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

Authorized official

Name

Richard Binstein, JD

Title

VP,Authorized Official

Phone

(713) 297-7000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1346279643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 N 17TH AVE STE 7",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4107 BARBICAN AVE",
            "address_2": "SUITE 260",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544764143",
            "telephone_number": "715-359-8465",
            "fax_number": "715-359-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT & SPINE CLINIC LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "BINSTEIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VP,AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-297-7000",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Joseph Smith, D.O.
• Kari Lynne Smith, FNP-BC
• Renee Marie Smith, MD
• Tiffany Debroux Smith
• Yamin Soe-Htwe, MD
• Brittany Stark, OTR
• Trisha Stefonek, PSYD
• Hilary Steltenpohl, MD
• Jennifer Stieber
• Stine Eye Center, LLC

• Rehabilitation Clinic/Center in Weston, WI
• Providers in Weston, WI by specialty
• Rehabilitation Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.