1. Home
  2. Directory
  3. Tennessee
  4. Portland
  5. Specialist
  6. NPI Profile

SOUTHERN SPORTS MEDICINE PORTLAND
NPI 1417237728
Specialist in Portland, TN

Active since August 18, 2011
121 VILLAGE DR, STE 102 & 103, PORTLAND, TN 37148(615) 325-1180(615) 452-2668 Get Directions Write a Review

NPPES record last updated: August 18, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southern Sports Medicine Portland NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN SPORTS MEDICINE PORTLAND (NPI 1417237728) is a healthcare organization registered as a specialist in Portland, Tennessee and active in the NPI registry since August 2011. The organization lists Thomas L Gautsch, Owner, as its authorized official.

NPPES Registry Identity

NPI1417237728
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameSOUTHERN SPORTS MEDICINE PORTLAND
Location Address121 VILLAGE DR, STE 102 & 103Portland, TN 37148-1418
Mailing Address570 Hartsville PikeGallatin, TN 37066-2450 · (615) 452-3320 · Fax (615) 452-2668
Phone(615) 325-1180
Fax(615) 452-2668
Organization SubpartYesParent: Southern Sports Medicine Institute, Pllc
Authorized OfficialThomas L GautschOwner · (615) 452-3320
Enumeration DateAugust 18, 2011
✔ NPI 1417237728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TN · MD0000026910
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
121 VILLAGE DR, Portland, TN 37148
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELLY AMYX MSOT
Occupational Therapist
121 VILLAGE DR, SUITE 103
PORTLAND, TN 37148
Sumner County (615) 323-7575
MR. TREVOR BENJAMIN BRANDT DPT
Physical Therapist
121 VILLAGE DR, SUITE 103
PORTLAND, TN 37148
Sumner County (615) 323-7575
JASON A BRUNS BSPT
Physical Therapist
121 VILLAGE DR, 103
PORTLAND, TN 37148
Sumner County (615) 323-7575
ANDREA REED NP
Nurse Practitioner
121 VILLAGE DR, SUITE 101
PORTLAND, TN 37148
Sumner County (615) 325-2226

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Sports Medicine Portland's NPI number?

The NPI number for Southern Sports Medicine Portland is 1417237728. It was assigned to this organization in the NPPES registry on August 18, 2011.

Where is Southern Sports Medicine Portland located?

Southern Sports Medicine Portland is located at 121 Village Dr Ste 102 & 103, Portland, TN 37148. The listed phone number is (615) 325-1180.

What is Southern Sports Medicine Portland's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Southern Sports Medicine Portland was last updated on August 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.