Sports Medicine Orthopaedics & Podiatry Inc

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

SPORTS MEDICINE ORTHOPAEDICS & PODIATRY INC

Practice address

400 Massasoit Avenue
Suite 201
East Providence, RI 02914-2012

Phone

(401) 383-7753

Fax

(401) 383-8982

NPI assigned

Feb 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jack D Goldstein, MD

Title

President

Phone

(401) 383-7753

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638403200000",
    "number": "1407034994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MASSASOIT AVE STE 201",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029142020",
            "telephone_number": "401-383-7753",
            "fax_number": "401-383-8982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MASSASOIT AVENUE",
            "address_2": "SUITE 201",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029142012",
            "telephone_number": "401-383-7753",
            "fax_number": "401-383-8982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE ORTHOPAEDICS & PODIATRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-06",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-383-7753",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9020116",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.sportsmedcenter.com",
            "affiliation": "N",
            "endpointDescription": "Web site",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "health information",
            "address_1": "400 Massasoit Avenue",
            "address_2": "Suite 201",
            "city": "East Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029142012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Orthopaedic Surgery Physician in East Providence, RI
• Providers in East Providence, RI by specialty
• Orthopaedic Surgery Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2021; 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.