417 SPORTS MEDICINE AND ORTHOPEDICS LLC
NPI 1871105312
Family Medicine - Sports Medicine in Springfield, MO

Q: What is 417 Sports Medicine And Orthopedics LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Active since August 17, 2020

3328 S NATIONAL AVE, SPRINGFIELD, MO 65807(417) 771-3147 Get Directions Write a Review

NPPES record last updated: May 16, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 16, 2024, May 27, 2022, Nov 10, 2020 and 2 more (5 updates tracked since 2020).

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About 417 Sports Medicine And Orthopedics Llc NPPES

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

417 SPORTS MEDICINE AND ORTHOPEDICS LLC (NPI 1871105312) is a healthcare organization registered as a sports medicine in Springfield, Missouri and active in the NPI registry since August 2020. The organization lists Eric Gifford, Physician, as its authorized official.

NPPES Registry Identity

NPI1871105312

Entity TypeOrganization

Primary Taxonomy207QS0010X

Legal Business Name417 SPORTS MEDICINE AND ORTHOPEDICS LLC

Location Address3328 S NATIONAL AVESpringfield, MO 65807-7305

Mailing Address2100 E Norshire StSpringfield, MO 65804-7829 · (817) 825-5096

Phone(417) 771-3147

Organization SubpartNo

Authorized OfficialEric GiffordPhysician · (817) 825-5096

Enumeration DateAugust 17, 2020

Last NPPES UpdateMay 16, 20245 updates tracked since enumeration

NPPES CertifiedMay 16, 2024

✔ NPI 1871105312 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

3328 S NATIONAL AVE, Springfield, MO 65807

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Other Identifiers 1

Other7860260001National Supplier Clearing House

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

417 Sports Medicine And Orthopedics Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 2 clinicians reassign Medicare billing to 417 Sports Medicine And Orthopedics LLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Eric Gifford, M.D.

Sports Medicine

NPI 1144532490

3328 S NATIONAL AVE
Springfield, MO 65807

(417) 771-3147

✔ PECOS✔ Accepts MedicareSame address

Nathan Graff, NP-C, AT

Nurse Practitioner

NPI 1609195569

3328 S NATIONAL AVE
Springfield, MO 65807

(417) 771-3147

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 417 Sports Medicine And Orthopedics LLC's NPI number?

The NPI number for 417 Sports Medicine And Orthopedics LLC is 1871105312. It was assigned to this organization in the NPPES registry on August 17, 2020.

Where is 417 Sports Medicine And Orthopedics LLC located?

417 Sports Medicine And Orthopedics LLC is located at 3328 S National Ave, Springfield, MO 65807. The listed phone number is (417) 771-3147.

What is 417 Sports Medicine And Orthopedics LLC's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is 417 Sports Medicine And Orthopedics LLC enrolled in Medicare?

Yes. 417 Sports Medicine And Orthopedics LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through 417 Sports Medicine And Orthopedics LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to 417 Sports Medicine And Orthopedics LLC, in Nurse Practitioner and Sports Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does 417 Sports Medicine And Orthopedics LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 1 other insurer list 417 Sports Medicine And Orthopedics LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for 417 Sports Medicine And Orthopedics LLC was last updated on May 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.