The Sports Medicine Clinic

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

FA0102165 Issued in NM

Legal business name

THE SPORTS MEDICINE CLINIC

Practice address

2469 Corrales Rd
Suite A2
Corrales, NM 87048-9146

Phone

(505) 377-5733

NPI assigned

Nov 19, 2015

Organization subpart

No

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

Authorized official

Name

Joshua Peiper

Title

Operations Director

Phone

(505) 377-5733

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447891200000",
    "number": "1962876581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2469 CORRALES RD",
            "address_2": "SUITE A2",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870489146",
            "telephone_number": "505-377-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2469 CORRALES RD",
            "address_2": "SUITE A2",
            "city": "CORRALES",
            "state": "NM",
            "postal_code": "870489146",
            "telephone_number": "505-377-5733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPORTS MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-19",
        "last_updated": "2015-11-19",
        "status": "A",
        "authorized_official_last_name": "PEIPER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "505-377-5733"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NM",
            "license": "FA0102165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• C Dayne Sultrmeier Williams, OT
• Ana Sutulov Marin, CPT
• Shelby R Tarango, OT
• Thomas J. Taylor, MD, MPH
• Alyson P Thal, M.D.
• The Victorian House Sleep Center LLC
• Torres Medical Consultants, PC
• Francisco Y Torres, MD
• Jennifer Trainor, APRN
• Gerard Vaglio, LPCC

• Multi-Specialty Clinic/Center in Corrales, NM
• Providers in Corrales, NM by specialty
• Multi-Specialty Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2015; 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.