Orthopaedic & Sports Medicine Ctr PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

ORTHOPAEDIC & SPORTS MEDICINE CTR PC

Doing business as

The Orthopaedic & Sports Medicine Center

Practice address

888 White Plains Rd
Suite 105
Trumbull, CT 06611-4552

Phone

(203) 268-2882

Fax

(203) 452-3097

NPI assigned

Feb 23, 2007

Organization subpart

No

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

Authorized official

Name

Miss Kelly M Poulin I

Title

Practice Administrator

Phone

(203) 268-2882

Specialties & licenses 1

Addresses

Other names 1

• The Orthopaedic & Sports Medicine Center Doing business as

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1932234440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 WHITE PLAINS RD",
            "address_2": "SUITE 105",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114552",
            "telephone_number": "203-268-2882",
            "fax_number": "203-452-3097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "888 WHITE PLAINS RD",
            "address_2": "SUITE 105",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066114552",
            "telephone_number": "203-268-2882",
            "fax_number": "203-452-3097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC & SPORTS MEDICINE CTR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "POULIN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "203-268-2882",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_name_suffix": "I"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Orthopaedic & Sports Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Trumbull, CT
• Providers in Trumbull, CT by specialty
• Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; 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.