Desert Spine Sport & Joint Center

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

DESERT SPINE SPORT & JOINT CENTER

Practice address

36915 Cook St
103
Palm Desert, CA 92211-6067

Phone

(760) 340-1003

Fax

(760) 340-4844

NPI assigned

Aug 1, 2011

Last updated

Mar 31, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sohail S Ahmad, MDNPI 1366413270

Title

President/Owner

Phone

(760) 340-1003

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 2

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.

• Sohail S Ahmad, MD

  • Orthopaedic Surgery Physician
  • Palm Desert, CA
  • NPI 1366413270
  Medicare reassignment NPD Authorized official
• Nizar Isa Ibrahim, M.D.

  • Family Medicine Physician
  • Moreno Valley, CA
  • NPI 1740364926
  NPD (past)

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396224000000",
    "number": "1982982492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36915 COOK ST",
            "address_2": "103",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116067",
            "telephone_number": "760-340-1003",
            "fax_number": "760-340-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36915 COOK ST",
            "address_2": "103",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922116067",
            "telephone_number": "760-340-1003",
            "fax_number": "760-340-4844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT SPINE SPORT & JOINT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-01",
        "last_updated": "2014-03-31",
        "status": "A",
        "authorized_official_last_name": "AHMAD",
        "authorized_official_first_name": "SOHAIL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "760-340-1003",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desert Ophthalmology Medical Corporation
• Desert Physical Therapy
• Desert Premier Transportation, Inc.
• Desert Rose Assisted Living
• Desert Seniors Home Health, Inc.
• Desert Springs Behavioral Health
• Desert Vascular Institute, a Professional Medical Corporation (Desert Vascular Institute)
• Desert Vip Urgent Care
• Desertrx Pharmacy
• Rafael Desta

• Sports Medicine (Orthopaedic Surgery) Physician in Palm Desert, CA
• Providers in Palm Desert, CA by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.