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GREEN SPORTS MEDICINE INC NPI 1396210563


NPI Information

NPI: 1396210563
Provider Name: GREEN SPORTS MEDICINE INC

Doing Business As: GREEN SPORTS MEDICINE, INC.

Classification: Family Medicine - 207QS0010X
Entity Type: Organization

Specialization: Sports Medicine

CLIA Number: 05D2190808

Address:
2021 HERNDON AVE STE 201
CLOVIS, CA
ZIP 93611
Phone: (559) 981-5566
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GREEN SPORTS MEDICINE INC is a sports medicine family medicine in Clovis, CA. The provider is a family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. GREEN SPORTS MEDICINE INC NPI is 1396210563. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Green Sports Medicine, Inc..

The provider's business location address is:

2021 HERNDON AVE STE 201
CLOVIS, CA
ZIP 93611-101
Phone: (559) 981-5566
Fax: (559) 228-9989

The provider's authorized official is Erick Green .
The authorized official title is Md and has the following contact phone number (559) 813-3005.

The CLIA number assigned to this NPI record is 05D2190808 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/3/2018 and was last updated on 11/18/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineNo
2207QS0010XFamily MedicineSports MedicineYes
3207XX0005XOrthopaedic SurgerySports MedicineNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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