The S.P.O.R.T. Institute Medical Group, Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

20A5466 Issued in CA

Legal business name

THE S.P.O.R.T. INSTITUTE MEDICAL GROUP, INC.

Practice address

7525 Linda Vista Rd.
Suite C
San Diego, CA 92111

Phone

(858) 650-3030

Fax

(858) 650-3033

NPI assigned

Dec 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William Joseph Previte, D.O.NPI 1407904584

Title

Owner

Phone

(858) 650-3030

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• William Joseph Previte, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • San Diego, CA
  • NPI 1407904584
  NPD (past) Authorized official

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313020800000",
    "number": "1902089204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7525 LINDA VISTA RD.",
            "address_2": "SUITE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92111",
            "telephone_number": "858-650-3030",
            "fax_number": "858-650-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7525 LINDA VISTA RD.",
            "address_2": "SUITE C",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92111",
            "telephone_number": "858-650-3030",
            "fax_number": "858-650-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE S.P.O.R.T. INSTITUTE MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2011-08-11",
        "status": "A",
        "authorized_official_last_name": "PREVITE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-650-3030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "20A5466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in San Diego, CA
• Providers in San Diego, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.