Provider Type Icon

VALLEY SPORTS PHYSICIANS & ORTHOPEDIC MEDICINE NPI 1871799635


NPI Information

NPI: 1871799635
Provider Name: VALLEY SPORTS PHYSICIANS & ORTHOPEDIC MEDICINE

Doing Business As: VALLEY SPORTS PHYSICIANS

Classification: Neuromusculoskeletal Medicine, Sports Medicine - 204C00000X
Entity Type: Organization
Address:
54 W AVON RD
SUITE 202
AVON, CT
ZIP 06001
Phone: (860) 675-0357
Get Directions

VALLEY SPORTS PHYSICIANS & ORTHOPEDIC MEDICINE is a neuromusculoskeletal medicine sports medicine in Avon, CT. The provider is a Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/ VALLEY SPORTS PHYSICIANS & ORTHOPEDIC MEDICINE NPI is 1871799635. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Valley Sports Physicians.

The provider's business location address is:

54 W AVON RD
SUITE 202
AVON, CT
ZIP 06001-680
Phone: (860) 675-0357
Fax: (860) 675-0358

The provider's authorized official is Nichole Wedderburn .
The authorized official title is Office / Billing Manager and has the following contact phone number (860) 675-0357.

The enumeration date for this NPI number is 6/26/2007 and was last updated on 10/24/2007.


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
1204C00000XNeuromusculoskeletal Medicine, Sports Medicine000406CONNECTICUTNo
2207QS0010XFamily MedicineSports Medicine040264CONNECTICUTNo
3207QS0010XFamily MedicineSports Medicine000406CONNECTICUTNo
4204C00000XNeuromusculoskeletal Medicine, Sports Medicine040264CONNECTICUTYes

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
102849MEDICARE PINCONNECTICUT

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.