EASTERN SPORTS MEDICINE AND SPINE ASSOCIATES LLC
NPI 1679950950
Orthopaedic Surgery in South Windsor, CT

Active since May 06, 2015
2800 TAMARACK AVE, SUITE 104, SOUTH WINDSOR, CT 06074(860) 648-0814 Get Directions Write a Review

NPPES record last updated: May 6, 2015. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Orthopaedic Surgery

About EASTERN SPORTS MEDICINE AND SPINE ASSOCIATES LLC

This page provides the complete NPI Profile along with additional information for Eastern Sports Medicine And Spine Associates Llc, a provider established in South Windsor, Connecticut operating as a Orthopaedic Surgery. The healthcare provider is registered in the NPI registry with number 1679950950 assigned on May 2015. The practitioner's primary taxonomy code is 207X00000X with license number 038984 (CT). The provider is registered as an organization and their NPI record was last updated 11 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Cheryl Flanagan (Credentialer)

NPI
1679950950 Verify this NPI
Provider Name
EASTERN SPORTS MEDICINE AND SPINE ASSOCIATES LLC
Entity Type
Organization
Location Address
2800 TAMARACK AVE SUITE 104 SOUTH WINDSOR, CT 06074
Location Phone
(860) 648-0814
Mailing Address
99 EAST RIVER DR 5TH FLOOR EAST HARTFORD, CT 06108
Mailing Phone
(860) 282-4133
Mailing Fax
(860) 289-0746
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-06-2015
Last Update Date
05-06-2015
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Orthopaedic Surgery

Taxonomy Code
207X00000X
Type
Allopathic & Osteopathic Physicians
License No.
038984
License State
CT
Taxonomy Description
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

CHERYL FLANAGAN

Authorized Official Title
CREDENTIALER
Authorized Official Phone
(860) 282-4133

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Other Providers at the Same Location


The following 11 providers are registered at the same or a nearby location.

Otolaryngology
2800 TAMARACK AVE, SUITE 102
SOUTH WINDSOR, CT 06074
Ophthalmology
2800 TAMARACK AVE, SUITE 102
SOUTH WINDSOR, CT 06074
Ophthalmology
2800 TAMARACK AVE, SUITE 102
SOUTH WINDSOR, CT 06074
Otolaryngology
2800 TAMARACK AVE, SUITE 102
SOUTH WINDSOR, CT 06074
Clinic/Center (Radiology)
2800 TAMARACK AVE, SUITE 002
SOUTH WINDSOR, CT 06074
Physician Assistant (Medical)
2800 TAMARACK AVE, SUITE 104
SOUTH WINDSOR, CT 06074
Orthopaedic Surgery
2800 TAMARACK AVE, SUITE 106
SOUTH WINDSOR, CT 06074
Surgery
2800 TAMARACK AVE, SUITE 100
SOUTH WINDSOR, CT 06074
Physician Assistant (Surgical)
2800 TAMARACK AVE, SUITE 104
SOUTH WINDSOR, CT 06074
Health Educator
2800 TAMARACK AVE
SOUTH WINDSOR, CT 06074
Specialist
2800 TAMARACK AVE, SUITE 100
SOUTH WINDSOR, CT 06074

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1679950950, enumerated as an "organization" on May 06, 2015.

The provider is located at 2800 TAMARACK AVE SUITE 104 SOUTH WINDSOR, CT 06074 and the phone number is (860) 648-0814.

Orthopaedic Surgery with taxonomy code 207X00000X.