Modern Sports Medicine LLC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

Legal business name

MODERN SPORTS MEDICINE LLC

Practice address

8427 E Baseline Rd Ste 101
Mesa, AZ 85209-4381

Phone

(480) 306-6627

Fax

(480) 306-6696

NPI assigned

Sep 26, 2024

Organization subpart

No

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

Authorized official

Name

Joshua Adams

Title

Owner

Phone

(480) 306-6627

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1457179731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8427 E BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852094381",
            "telephone_number": "480-306-6627",
            "fax_number": "480-306-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8427 E BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852094381",
            "telephone_number": "480-306-6627",
            "fax_number": "480-306-6696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN SPORTS MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-26",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-306-6627"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mobile Medical Providers of Arizona, LLC
• Mobilecaremd LLC
• Modern Ambulatory Surgery Center, PC
• Modern Dental Professionals - Arizona PC (Brightnow Mesa Country Club Dr)
• Modern Diagnostic Imaging, P.C.
• Modern Sports Medicine LLC
• Modern Vascular Institute LLC
• Modern Vascular of Mesa, LLC
• Meet Modi
• Robert Albin Modic, MD

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.