NPIMap

Organization Active NPI

Sports and Spine Physical Therapy NC Inc

Doing business as Sportspine

  • Physical Therapy Clinic/Center
  • Charlotte, NC
National Provider Identifier
1982651618
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SPORTS AND SPINE PHYSICAL THERAPY NC INC
Doing business as
Sportspine
Practice address
3627 Beatties Ford Rd
Charlotte, NC 28216-3249
Phone
(704) 394-6677
NPI assigned
May 28, 2006
Last updated
Nov 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Authorized official

Name
Leon Anderson III, PTNPI 1669413910
Title
President
Phone
(216) 593-7070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

3627 Beatties Ford Rd
Charlotte, NC 28216-3249

Mailing address

3627 Beatties Ford Rd
Charlotte, NC 28216-3249
Phone (704) 394-6677

Other identifiers 2

IdentifierTypeStateIssuer
GP4663MedicaidSC
7212192MedicaidNC

Other names 1

  • Sportspine Doing business as

National Provider Directory

National Provider Directory

Locations

3627 Beatties Ford Rd
Charlotte, NC 28216
Phone (704) 335-0806

3627 Beatties Ford Rd
Ste 200
Charlotte, NC 28216
Phone (704) 394-6677

1609 Constitution Blvd
#200
Rock Hill, SC 29732
Phone (803) 980-5252

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1982651618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3627 BEATTIES FORD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282163249",
            "telephone_number": "704-394-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 BEATTIES FORD RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282163249",
            "telephone_number": "704-394-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS AND SPINE PHYSICAL THERAPY NC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "LEON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-593-7070",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4663",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212192",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sportspine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.