NPIMap

Organization Active NPI

Sport & Spine Clinic LP

Doing business as Sport & Spine Clinic of Edgar

  • Rehabilitation Clinic/Center
  • Edgar, WI
National Provider Identifier
1942238167
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
SPORT & SPINE CLINIC LP
Doing business as
Sport & Spine Clinic of Edgar
Practice address
325 S.Third Avenue
Suite B
Edgar, WI 54426
Phone
(715) 352-2780
Fax
(715) 352-2781
NPI assigned
Jun 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Authorized official

Name
Richard Binstein
Title
Evp
Phone
(713) 297-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

325 S.Third Avenue
Suite B
Edgar, WI 54426

Mailing address

327 N 17TH Ave Ste 7
Wausau, WI 54401-4283

Other names 1

  • Sport & Spine Clinic of Edgar Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642377600000",
    "number": "1942238167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 N 17TH AVE STE 7",
            "city": "WAUSAU",
            "state": "WI",
            "postal_code": "544014283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S.THIRD AVENUE",
            "address_2": "SUITE B",
            "city": "EDGAR",
            "state": "WI",
            "postal_code": "54426",
            "telephone_number": "715-352-2780",
            "fax_number": "715-352-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT & SPINE CLINIC LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A",
        "authorized_official_last_name": "BINSTEIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "713-297-7000"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sport & Spine Clinic of Edgar",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sport & Spine Clinic of Edgar",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edgar, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.