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 | 133VN1501X | Dietitian, Registered | Nutrition, Sports Dietetics | | | No |
| 2 | 163WX0800X | Registered Nurse | Orthopedic | | | No |
| 3 | 207PS0010X | Emergency Medicine | Sports Medicine | | | No |
| 4 | 207QS0010X | Family Medicine | Sports Medicine | | | No |
| 5 | 207RS0010X | Internal Medicine | Sports Medicine | | | No |
| 6 | 2081P2900X | Physical Medicine & Rehabilitation | Pain Medicine | | | No |
| 7 | 2081S0010X | Physical Medicine & Rehabilitation | Sports Medicine | | | No |
| 8 | 2083S0010X | Preventive Medicine | Sports Medicine | | | No |
| 9 | 208VP0000X | Pain Medicine | Pain Medicine | | | No |
| 10 | 225100000X | Physical Therapist | | | | No |
| 11 | 2251E1200X | Physical Therapist | Ergonomics | | | No |
| 12 | 2251S0007X | Physical Therapist | Sports | | | No |
| 13 | 2251X0800X | Physical Therapist | Orthopedic | | | No |
| 14 | 225XP0019X | Occupational Therapist | Physical Rehabilitation | | | No |
| 15 | 208100000X | Physical Medicine & Rehabilitation | | | | Yes |