The PT Center for Sports Medicine

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

003740 Issued in OH

Legal business name

THE PT CENTER FOR SPORTS MEDICINE

Practice address

2660 W Market St Ste 300
Fairlawn, OH 44333-4209

Phone

(330) 869-2635

Fax

(330) 869-8315

NPI assigned

Oct 19, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Tina Outwater

Title

Office Manager

Phone

(330) 869-2635

Specialties & licenses 1

Addresses

Tax ID family

The PT Center for Sports Medicine2 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.

• The PT Center for Sports Medicine

  • Athletic Trainer
  • Fairlawn, OH
  • NPI 1578815973
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin L. Outwater Sr., PT, ATC

  • Physical Therapist
  • Fairlawn, OH
  • NPI 1114922556
  NPD (past)

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1972856524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 W MARKET ST STE 300",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334209",
            "telephone_number": "330-869-2635",
            "fax_number": "330-869-8315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 W MARKET ST STE 300",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334209",
            "telephone_number": "330-869-2635",
            "fax_number": "330-869-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PT CENTER FOR SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "OUTWATER",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "330-869-2635",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OH",
            "license": "003740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle Rini Telford, LISW
• Megan Elizabeth Tennant, PTA
• The Center for Integrative Health LLC
• The Eye Site in Copley, LLC
• The PT Center for Sports Medicine
• The Tamarkin Company
• Thomas Flickinger OD PHD LLC
• Thomas H. Handel OD, Inc.
• Clinton Eugene Thomas III
• Michelle Dionne Thomas, LPN

• Athletic Trainer in Fairlawn, OH
• Providers in Fairlawn, OH by specialty
• Athletic Trainer in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.