Interventional Spine & Sports Medicine, PC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

040593 Issued in CT

Legal business name

INTERVENTIONAL SPINE & SPORTS MEDICINE, PC

Practice address

935 Rainbow TRL
Orange, CT 06477-1034

Phone

(203) 645-8859

NPI assigned

Jul 9, 2010

Organization subpart

No

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

Authorized official

Name

Bhavesh R Patel, MD

Title

President

Phone

(203) 645-8859

Specialties & licenses 1

Addresses

Tax ID family

Interventional Spine Sport2 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.

• Interventional Spine & Sports Medicine, PC

  • Physical Medicine & Rehabilitation Physician
  • Middlebury, CT
  • NPI 1588983415
  NPD tax ID

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1871805697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 RAINBOW TRL",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064771034",
            "telephone_number": "203-645-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 RAINBOW TRL",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064771034",
            "telephone_number": "203-645-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE & SPORTS MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "BHAVESH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-645-8859",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CT",
            "license": "040593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Impact Health P.C.
• Impact Health Psych PC
• Loyd Kenneth Inabinet
• Reana Ingram
• Integrative Wellness & Therapy
• Robert Christopher Isner Jr., PHARMD
• Eric D Jackson, PHD
• Willow Lotus Jackson, RN
• Lily Jacobson
• Sandeep Jagini, DMD

• Physical Medicine & Rehabilitation Physician in Orange, CT
• Providers in Orange, CT by specialty
• Physical Medicine & Rehabilitation Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.