DFW Sports Medicine, PLLC

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

DFW SPORTS MEDICINE, PLLC

Practice address

4833 Medical Center Dr Ste 6E
McKinney, TX 75069-1898

Phone

(469) 430-9380

Fax

(469) 242-9539

NPI assigned

Dec 7, 2020

Organization subpart

No

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

Authorized official

Name

Rathna Nuti, MDNPI 1295171668

Title

Physician

Phone

(214) 738-6169

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23179/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rathna Rao Nuti, M.D.

  • Sports Medicine (Family Medicine) Physician
  • McKinney, TX
  • NPI 1295171668
  Medicare reassignment NPD Authorized official
• Steve Jay Hong, MD

  • Interventional Pain Medicine Physician
  • Frisco, TX
  • NPI 1093152639
  NPD

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1619573532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 GLEN RIDGE DR",
            "city": "MURPHY",
            "state": "TX",
            "postal_code": "750944206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4833 MEDICAL CENTER DR STE 6E",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750691898",
            "telephone_number": "469-430-9380",
            "fax_number": "469-242-9539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1850 Lakepointe Dr Ste 700",
            "address_purpose": "LOCATION",
            "city": "Lewisville",
            "state": "TX",
            "postal_code": "750576442",
            "country_code": "US",
            "telephone_number": "469-430-9380",
            "fax_number": "469-242-9539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DFW SPORTS MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-07",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "NUTI",
        "authorized_official_first_name": "RATHNA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "214-738-6169",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John M Devore, DC
• Dewayne Smith
• Ian Thomas Dewey, BCBA
• Blessing E. Dexter, LPCS, LSSP
• DFW Lao Heritage
• Diamondback Medical LLC
• Diamondback Medical Solutions PLLC
• Elaine Maria Dibartolo, LPC-ASSOCIATE
• Nick Dietrick, LPC
• Raphael Dikas, PHARMD

• Sports Medicine (Family Medicine) Physician in McKinney, TX
• Providers in McKinney, TX by specialty
• Sports Medicine (Family Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.