SPORTS MEDICINE – NPI #1871674754
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

SPORTS MEDICINE is a provider located in HATTIESBURG, MS. NPPES has assigned the NPI number 1871674754 to SPORTS MEDICINE on October 18, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “SPORTS MEDICINE” is a dba name, the actual legal business name for this organization is HATTIESBURG CLINIC PA. 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 5 years ago on Feb 23, 2021. 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 SPORTS MEDICINE below.

NPI Profile for
HATTIESBURG CLINIC PA

NPI Number
1871674754
Enumeration Date

(more than 19 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
HATTIESBURG CLINIC PA
Doing Business As (dba): SPORTS MEDICINE
Primary location
415 S 28TH AVE
HATTIESBURG, MS 39401-7246
Phone: (601) 579-5406 Fax: (601) 268-5756
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
BRYAN BATSON
EXECUTIVE DIRECTOR
Phone: (601) 264-6000
Updated
Certification Date
Feb 23, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for SPORTS MEDICINE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMS06389072
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)

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.