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SPORT CLINIC PC NPI 1528275484


NPI Information

NPI: 1528275484
Provider Name: SPORT CLINIC, PC

Other Name: MITCHELL ORTHOPAEDIC CENTER

Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1222 E 7TH AVE
MITCHELL, SD
ZIP 57301
Phone: (605) 996-7077
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SPORT CLINIC, PC is a specialist in Mitchell, SD. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SPORT CLINIC, PC NPI is 1528275484. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Mitchell Orthopaedic Center.

The provider's business location address is:

1222 E 7TH AVE
MITCHELL, SD
ZIP 57301-309
Phone: (605) 996-7077
Fax: (605) 996-0297

The provider's authorized official is Robert E Mcwhirter .
The authorized official title is Owner and has the following contact phone number (605) 996-7077.

The enumeration date for this NPI number is 5/17/2007 and was last updated on 4/6/2010.


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
1174400000XSpecialist1694SOUTH DAKOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10430600001MEDICARE NSCSOUTH DAKOTA
29794MEDICARE ID-TYPE UNSPECIFIEDSOUTH DAKOTA
3B99295MEDICARE UPINSOUTH DAKOTA
46400430MEDICAIDSOUTH DAKOTA

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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