Sports Med Denton LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3120320 Issued in TX

Legal business name

SPORTS MED DENTON LLC

Practice address

2318 San Jacinto Blvd
Ste. 108
Denton, TX 76205-7535

Phone

(940) 380-9111

Fax

(940) 380-9112

NPI assigned

Jan 6, 2017

Organization subpart

No

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

Authorized official

Name

Katherine Dieringer

Title

Owner/Administrator

Phone

(940) 380-9111

Specialties & licenses 1

Addresses

Other names 1

• D&D Sports Med Denton Doing business as

Tax ID family

D and D Sports Med Denton2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Sports Med Denton LLC

  • Physical Therapy Clinic/Center
  • Denton, TX
  • NPI 1225073521
  NPD tax ID

Locations

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483660800000",
    "number": "1942746532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2318 SAN JACINTO BLVD",
            "address_2": "STE. 108",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762057535",
            "telephone_number": "940-380-9111",
            "fax_number": "940-380-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2318 SAN JACINTO BLVD",
            "address_2": "STE. 108",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762057535",
            "telephone_number": "940-380-9111",
            "fax_number": "940-380-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MED DENTON LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-06",
        "last_updated": "2017-01-06",
        "status": "A",
        "authorized_official_last_name": "DIERINGER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "940-380-9111"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "3120320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D&D Sports Med Denton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Solomon Blake Spiegel, D.O.
• Amanda Marie Spies, APRN, FNP-C
• Sally Elizabeth Spiller, LPC, MS
• Michael Ray Spivey, MD
• Sports Med Denton LLC
• Staci Denise Sprabary, C.PH.T
• Dianne Srinilta
• Ramesh Srinivasan, MD
• Noelle R St. Germain-Sehr, PH.D, LPC-S, NCC
• Britton Burke Staheli, MD, MBA

• Physical Therapist in Denton, TX
• Providers in Denton, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; 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.