Sports Medicine Center of Metro Detroit PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

JC039731 Issued in MI

Legal business name

SPORTS MEDICINE CENTER OF METRO DETROIT PC

Practice address

5600 Crooks Rd
Suite 103
Troy, MI 48098-2811

Phone

(248) 813-0002

Fax

(248) 813-0007

NPI assigned

Mar 22, 2007

Organization subpart

No

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

Authorized official

Name

Miss Jackie Tremonti

Title

Biller

Phone

(248) 813-0002

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1912023458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 CROOKS RD",
            "address_2": "SUITE 103",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982811",
            "telephone_number": "248-813-0002",
            "fax_number": "248-813-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 CROOKS RD",
            "address_2": "SUITE 103",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982811",
            "telephone_number": "248-813-0002",
            "fax_number": "248-813-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE CENTER OF METRO DETROIT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "TREMONTI",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "248-813-0002",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "JC039731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1741033",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Troy, MI
• Providers in Troy, MI by specialty
• Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.