The Sports Medicine Shop, Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

THE SPORTS MEDICINE SHOP, INC

Practice address

1205 Ella St Ste a
Anderson, SC 29621-4811

Phone

(864) 760-0909

Fax

(866) 594-2740

NPI assigned

Feb 15, 2012

Organization subpart

No

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

Authorized official

Name

Jennifer Jeanne Smith

Title

VP Operations

Phone

(864) 760-0909

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1508139908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 ELLA ST STE A",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214811",
            "telephone_number": "864-760-0909",
            "fax_number": "866-594-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 ELLA ST STE A",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296214811",
            "telephone_number": "864-760-0909",
            "fax_number": "866-594-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPORTS MEDICINE SHOP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "VP OPERATIONS",
        "authorized_official_telephone_number": "864-760-0909"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DE3476",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tamara Michelle Thacker, RN
• Mark W Thayer, DC
• The Chiropractic Thayerapy Center
• The Hand Center PA
• The Mending Hearts Initiative
• Thomas J. Sullivan, Jr. MD, PA
• Jennifer M Thomas, MD
• Jimmy Thomas
• Richard Phillip Thomas, D.O.
• Tracie L. Thomas, LPC

• Durable Medical Equipment & Medical Supplies in Anderson, SC
• Providers in Anderson, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.