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CLARKSVILLE SPORTSMED & WELLNESS NPI 1588941942


NPI Information

NPI: 1588941942
Provider Name: CLARKSVILLE SPORTSMED & WELLNESS
Classification: Family Medicine - 207QS0010X
Entity Type: Organization

Specialization: Sports Medicine

Address:
2690 MADISON STREET
STE 130
CLARKSVILLE, TN
ZIP 37043
Phone: (931) 645-6990
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CLARKSVILLE SPORTSMED & WELLNESS is a sports medicine family medicine in Clarksville, TN. 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. CLARKSVILLE SPORTSMED & WELLNESS NPI is 1588941942. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2690 MADISON STREET
STE 130
CLARKSVILLE, TN
ZIP 37043-458
Phone: (931) 645-6990
Fax: (931) 245-1720

The provider's authorized official is Syed Ahmed Naseeruddin .
The authorized official title is Medical Director and has the following contact phone number (931) 645-6990.

The enumeration date for this NPI number is 11/12/2011 and was last updated on 6/20/2012.


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
1363LF0000XNurse PractitionerFamilyAPN15967TENNESSEENo
2207QS0010XFamily MedicineSports MedicineMD45045TENNESSEEYes

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
1103G702581MEDICARE PINTENNESSEE
24324612OTHERTENNESSEEBCBSTN
31527840MEDICAIDTENNESSEE

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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