The Sports Centre, LLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

47438 Issued in CT

Legal business name

THE SPORTS CENTRE, LLC

Practice address

5 Founders St Ste 204
Willimantic, CT 06226-2057

Phone

(860) 456-1780

NPI assigned

Oct 14, 2010

Last updated

Dec 23, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert O'Connor, MD

Title

Owner

Phone

(860) 456-1780

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Patrice Larae Martin, LPC

  • Professional Counselor
  • Mansfield Center, CT
  • NPI 1043009913
  NPD (past)
• Sarah Casey Mitchell, MSW

  • Clinical Social Worker
  • Norwich, CT
  • NPI 1144428970
  NPD (past)
• Blenda D Williams, MSW

  • Addiction (Substance Use Disorder) Counselor
  • Mansfield Center, CT
  • NPI 1730330952
  NPD (past)

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

{
    "created_epoch": "1287014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513987200000",
    "number": "1609186485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 STORRS ROAD",
            "city": "MANSFIELD CENTER",
            "state": "CT",
            "postal_code": "062501638",
            "telephone_number": "860-456-1780",
            "fax_number": "860-456-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 FOUNDERS ST STE 204",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062262057",
            "telephone_number": "860-456-1780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPORTS CENTRE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-14",
        "last_updated": "2017-12-23",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-456-1780",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "CT",
            "license": "47438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• The Stop & Shop Supermarket Company, LLC (Stop and Shop Pharmacy #674)
• Woodrow F Tinsley III, LMSW
• Griselle Torres
• Maria Torres
• Nestor Enrique Torres, MD

• Sports Medicine (Orthopaedic Surgery) Physician in Willimantic, CT
• Providers in Willimantic, CT by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2017; 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.