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MODERN SPORTS MEDICINE LLC NPI 1912683699


NPI Information

NPI: 1912683699
Provider Name: MODERN SPORTS MEDICINE LLC
Classification: Physical Medicine & Rehabilitation - 2081S0010X
Entity Type: Organization

Specialization: Sports Medicine

Address:
5590 W CHANDLER BLVD STE 4
CHANDLER, AZ
ZIP 85226
Phone: (480) 306-6627
Get Directions

MODERN SPORTS MEDICINE LLC is a sports medicine physical medicine rehabilitation in Chandler, AZ. The provider is a physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. MODERN SPORTS MEDICINE LLC NPI is 1912683699. The provider is registered as an organization entity type.

The provider's business location address is:

5590 W CHANDLER BLVD STE 4
CHANDLER, AZ
ZIP 85226-744
Phone: (480) 306-6627
Fax: (480) 306-6696

The provider's authorized official is Susan Fruchtman .
The authorized official title is Vp Of Rcm And Credentialing and has the following contact phone number (480) 863-6269.

The enumeration date for this NPI number is 6/26/2023 and was last updated on 6/26/2023.


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
1261QM1300XClinic/CenterMulti-SpecialtyNo
22251X0800XPhysical TherapistOrthopedicNo
3207QS0010XFamily MedicineSports MedicineNo
4225100000XPhysical TherapistNo
52081S0010XPhysical Medicine & RehabilitationSports MedicineYes

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: 5/5/2024

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