NPIMap

Organization Active NPI

Sport Development Services Inc.

  • Health Educator
  • Boston, MA
National Provider Identifier
1942962949
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Legal business name
SPORT DEVELOPMENT SERVICES INC.
Practice address
19 Boyden St
Boston, MA 02124-3212
Phone
(781) 244-0894
NPI assigned
Oct 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Authorized official

Name
Mr. Floyd Ashton Williams-Agnew
Title
Executive Director/Founder/Mentor
Phone
(781) 244-0894

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health EducatorGroup: 193400000X SINGLE SPECIALTY GROUP 174H00000X Primary

Addresses

Primary practice location

19 Boyden St
Boston, MA 02124-3212

Mailing address

19 Boyden St
Boston, MA 02124-3212

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL floyd.williams@sportdevelopmentinc.onmicrosoft.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory
Tax ID family
Sport Development Services Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1942962949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BOYDEN ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021243212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BOYDEN ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021243212",
            "telephone_number": "781-244-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORT DEVELOPMENT SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-07",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS-AGNEW",
        "authorized_official_first_name": "FLOYD",
        "authorized_official_middle_name": "ASHTON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/FOUNDER/MENTOR",
        "authorized_official_telephone_number": "781-244-0894",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "floyd.williams@sportdevelopmentinc.onmicrosoft.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "19 Boyden St",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021243212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.