Sport Medicine and Orthopaedic Center Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SPORT MEDICINE AND ORTHOPAEDIC CENTER INC

Practice address

5801 Harbour View Blvd Ste 201
Suffolk, VA 23435-2657

Phone

(757) 842-7010

NPI assigned

Oct 15, 2021

Organization subpart

No

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

Authorized official

Name

Riannon Ruscitto

Title

Credentialing Specialist

Phone

(757) 842-7010

Specialties & licenses 1

Addresses

Tax ID family

Sports Medicine Orth4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Sport Medicine and Orthopaedic Center Inc

  dba Sports Medicine Othopaedics Center

  • Orthopaedic Surgery Physician
  • Suffolk, VA
  • NPI 1619445426
  NPD tax ID
• Sport Medicine and Orthopaedic Center Inc

  dba Sports Medicine Othopaedics Center

  • Orthopaedic Surgery Physician
  • Suffolk, VA
  • NPI 1699243402
  NPD tax ID
• Sports Medicine and Orthopaedic Center

  • Physical Therapist
  • Chesapeake, VA
  • NPI 1386303832
  NPD tax ID

Locations

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

{
    "created_epoch": "1634256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1932862133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DISCOVERY DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233203843",
            "telephone_number": "757-842-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 HARBOUR VIEW BLVD STE 201",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234352657",
            "telephone_number": "757-842-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT MEDICINE AND ORTHOPAEDIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-15",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "RUSCITTO",
        "authorized_official_first_name": "RIANNON",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "757-842-7010"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spectrum Behavioral Consulting LLC
• Briana K Spellman, LPC
• Spinal Source Chiropractic LLC
• Sport Medicine and Orthopaedic Center Inc (Sports Medicine Othopaedics Center)
• Sport Medicine and Orthopaedic Center Inc (Sports Medicine Othopaedics Center)
• John David Spring, PA-C
• Michele Elizabeth Sprosty, MD
• Ray St John
• Nathan Stahr, O.D.
• Samantha T Stahr, OD

• Durable Medical Equipment & Medical Supplies in Suffolk, VA
• Providers in Suffolk, VA by specialty
• Durable Medical Equipment & Medical Supplies in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.