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 Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207XX0005X | Orthopaedic Surgery | Sports Medicine | | | No |
| 2 | 213ES0103X | Podiatrist | Foot & Ankle Surgery | | | No |
| 3 | 363A00000X | Physician Assistant | | | | No |
| 4 | 363L00000X | Nurse Practitioner | | | | No |
| 5 | 207L00000X | Anesthesiology | | | | No |
| 6 | 207LP2900X | Anesthesiology | Pain Medicine | | | No |
| 7 | 207QS0010X | Family Medicine | Sports Medicine | | | No |
| 8 | 207T00000X | Neurological Surgery | | | | No |
| 9 | 207X00000X | Orthopaedic Surgery | | | | No |
| 10 | 207XX0004X | Orthopaedic Surgery | Foot and Ankle Surgery | | | No |
| 11 | 207XS0106X | Orthopaedic Surgery | Hand Surgery | | | No |
| 12 | 332B00000X | Durable Medical Equipment & Medical Supplies | | | | Yes |