AT DIRECT SPORTS MEDICINE, LLC – NPI #1720507262
Preventive Medicine

A preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries.

Health Care Provider Taxonomy Code for Preventive Medicine

AT DIRECT SPORTS MEDICINE, LLC is a provider located in MESA, AZ. NPPES has assigned the NPI number 1720507262 to AT DIRECT SPORTS MEDICINE, LLC on September 15, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 2083S0010X from the Health Care Provider Taxonomy code set, which is classified as Preventive Medicine, specializing in Sports Medicine

The NPI profile was previously updated about 4 years ago on Jul 21, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AT DIRECT SPORTS MEDICINE, LLC below.

NPI Profile for
AT DIRECT SPORTS MEDICINE, LLC

NPI Number
1720507262
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AT DIRECT SPORTS MEDICINE, LLC
Primary location
6424 E FAIRFIELD ST
MESA, AZ 85205-6042
Phone: (520) 235-0067 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
CASEY ERICKSON
OWNER/ATHLETIC TRAINER
Phone: (520) 235-0067
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2083S0010X
- Preventive Medicine / Sports Medicine (Primary)		 AZ 1318

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.