Sportopedics Medical Shoppe Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SPORTOPEDICS MEDICAL SHOPPE INC.

Practice address

1222 S Patterson Blvd
Suite #130
Dayton, OH 45402-2684

Phone

(937) 461-2663

Fax

(937) 461-3448

NPI assigned

Jan 3, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Richard A. Dunlap

Title

Owner/President

Phone

(937) 475-7210

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340841600000",
    "number": "1932187655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "SUITE #130",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-461-2663",
            "fax_number": "937-461-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 S PATTERSON BLVD",
            "address_2": "SUITE #130",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454022684",
            "telephone_number": "937-461-2663",
            "fax_number": "937-461-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTOPEDICS MEDICAL SHOPPE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-03",
        "last_updated": "2012-06-28",
        "status": "A",
        "authorized_official_last_name": "DUNLAP",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "937-475-7210",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0301408",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Blake Splawinski
• Linda Carol Spokane, LSW
• Christine Marie Sponsel, COTA/L
• Zachary Spoon, CT
• Carson Elizabeth Spornhauer, DDS
• Bryan Spreng
• Jacole R Spriggs, RN
• Johnique Springer, LSW
• Rachel Springer, LPN
• Linda Ann Springman, M.S. CCC/SLP

• Durable Medical Equipment & Medical Supplies in Dayton, OH
• Providers in Dayton, OH by specialty
• Durable Medical Equipment & Medical Supplies in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.