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417 SPORTS MEDICINE AND ORTHOPEDICS LLC NPI 1871105312


NPI Information

NPI: 1871105312
Provider Name: 417 SPORTS MEDICINE AND ORTHOPEDICS LLC
Classification: Family Medicine - 207QS0010X
Entity Type: Organization

Specialization: Sports Medicine

CLIA Number: 26D2205940

Address:
330 W PLAINVIEW RD STE F
SPRINGFIELD, MO
ZIP 65810
Phone: (417) 771-3147
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417 SPORTS MEDICINE AND ORTHOPEDICS LLC is a sports medicine family medicine in Springfield, MO. 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. 417 SPORTS MEDICINE AND ORTHOPEDICS LLC NPI is 1871105312. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

330 W PLAINVIEW RD STE F
SPRINGFIELD, MO
ZIP 65810-672
Phone: (417) 771-3147

The provider's authorized official is Eric Gifford .
The authorized official title is Physician and has the following contact phone number (817) 825-5096.

The CLIA number assigned to this NPI record is 26D2205940 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/17/2020 and was last updated on 5/27/2022.


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
1207QS0010XFamily MedicineSports MedicineYes

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
17860260001OTHERNATIONAL SUPPLIER CLEARING HOUSE

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.