Sport and Spine Rehab

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

2011030640 Issued in MO

Legal business name

SPORT AND SPINE REHAB

Practice address

303 N Keene St
Ste 102
Columbia, MO 65201-7193

Phone

(573) 443-0225

NPI assigned

Jul 31, 2014

Organization subpart

No

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

Authorized official

Name

Marty Morris

Title

Manager

Phone

(573) 443-0225

Specialties & licenses 1

Addresses

Tax ID family

Central Missouri Physical Therapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Central Missouri Physical Therapy

  • Physical Therapy Clinic/Center
  • Moberly, MO
  • NPI 1215982095
  NPD tax ID

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1861800070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 N KEENE ST",
            "address_2": "STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017193",
            "telephone_number": "573-443-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 N KEENE ST",
            "address_2": "STE 102",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652017193",
            "telephone_number": "573-443-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT AND SPINE REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "MARTY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "573-443-0225"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MO",
            "license": "2011030640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Spiers, MA, PLPC
• Robert Wade Spilman
• Savana Spitz, PT
• Linda E Spollen, MD
• Christopher Joseph Sporleder, DO
• Tracy Sprague
• Ginger Spratt, RRT
• Lori A. Spry, MSW, LCSW
• SPS Practice Group, LLC
• Alexandria Spurgeon, MD

• Health Maintenance Organization in Columbia, MO
• Providers in Columbia, MO by specialty
• Health Maintenance Organization in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.