Professional Sports Care Management Inc

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

PROFESSIONAL SPORTS CARE MANAGEMENT INC

Doing business as

Healthsouth Sports Medicine & Rehab Ctr

Practice address

445 Godwin Ave
Midland Park, NJ 07432

Phone

(201) 444-4991

Fax

(201) 444-2593

NPI assigned

Mar 29, 2006

Reactivated

Dec 12, 2007

Organization subpart

No

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

Authorized official

Name

Michael E Tarvin

Title

Vice President

Phone

(717) 975-4503

Specialties & licenses 2

Addresses

Other names 1

• Healthsouth Sports Medicine & Rehab Ctr Doing business as

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1659332773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9716 OLD GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "17055",
            "telephone_number": "717-975-4503",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 GODWIN AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "07432",
            "telephone_number": "201-444-4991",
            "fax_number": "201-444-2593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL SPORTS CARE MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2007-12-12",
        "deactivation_date": "2007-10-29",
        "reactivation_date": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-975-4503"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthsouth Sports Medicine & Rehab Ctr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pamela Holly Pollack, DPT
• Carrie Lynne Polster, D.M.D.
• Kelly Poole, LMHC
• Laura Theresa Porcaro, LCSW
• Karola Prinz, M.D.
• Prospect Medical Office, LLC
• Prospect Medical Office, LLC
• Quest Autism Programs Inc.
• Raise the Bar Physical Therapy PC
• Mario Edward Ramos, DMD

• Rehabilitation Clinic/Center in Midland Park, NJ
• Providers in Midland Park, NJ by specialty
• Rehabilitation Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.