Institute for Collegiate Sports Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

INSTITUTE FOR COLLEGIATE SPORTS MEDICINE

Practice address

3511 Sahara Springs Blvd
Pompano Beach, FL 33069-6101

Phone

(954) 204-5428

NPI assigned

Jan 15, 2013

Last updated

Jan 15, 2013By 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

Brian Anderson

Title

President

Phone

(954) 204-5428

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358208000000",
    "number": "1730426305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669582",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330669582",
            "telephone_number": "954-204-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 SAHARA SPRINGS BLVD",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330696101",
            "telephone_number": "954-204-5428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE FOR COLLEGIATE SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-15",
        "last_updated": "2013-01-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-204-5428"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Pompano Beach, FL
• Providers in Pompano Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2013; 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.