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PURDUE SPORTS MEDICINE WL NPI 1053712570


NPI Information

NPI: 1053712570
Provider Name: PURDUE SPORTS MEDICINE WL
Classification: Physical Therapist - 2251X0800X
Entity Type: Organization

Specialization: Orthopedic

Address:
900 JOHN R WOODEN DRIVE
MACKEY ARENA
WEST LAFAYETTE, IN
ZIP 47907
Phone: (765) 494-3245
Get Directions

PURDUE SPORTS MEDICINE WL is an orthopedic physical therapist in West Lafayette, IN. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice. PURDUE SPORTS MEDICINE WL NPI is 1053712570. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

900 JOHN R WOODEN DRIVE
MACKEY ARENA
WEST LAFAYETTE, IN
ZIP 47907
Phone: (765) 494-3245
Fax: (765) 494-9899

The provider's authorized official is Joan M Vaughan .
The authorized official title is Hipaa Privacy Officer and has the following contact phone number (765) 496-1927.

The enumeration date for this NPI number is 9/16/2014 and was last updated on 10/24/2014.


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
1207RS0010XInternal MedicineSports MedicineNo
22255A2300XSpecialist/TechnologistAthletic TrainerNo
32251X0800XPhysical TherapistOrthopedicYes

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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