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 | 2083S0010X | Preventive Medicine | Sports Medicine | | | No |
| 2 | 207PS0010X | Emergency Medicine | Sports Medicine | | | No |
| 3 | 207QS0010X | Family Medicine | Sports Medicine | | | No |
| 4 | 207RS0010X | Internal Medicine | Sports Medicine | | | No |
| 5 | 207XX0005X | Orthopaedic Surgery | Sports Medicine | | | No |
| 6 | 207XX0801X | Orthopaedic Surgery | Orthopaedic Trauma | | | No |
| 7 | 2081S0010X | Physical Medicine & Rehabilitation | Sports Medicine | | | No |
| 8 | 2080S0010X | Pediatrics | Sports Medicine | | | No |
| 9 | 363A00000X | Physician Assistant | | | | No |
| 10 | 363L00000X | Nurse Practitioner | | | | Yes |