Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southern Sports Medicine Portland

Organization Specialist · NPI 1417237728

Southern Sports Medicine Portland is a Specialist in Portland, Tennessee. Licensed in Tennessee. Registered with an NPI since 2011.

Licensed in
TN
In the registry since
2011

Practice location Address checks out

121 Village Dr Ste 102 & 103
Portland, TN 37148-1418
Phone: (615) 325-1180
Fax: (615) 452-2668
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence MD0000026910 (TN)

Record details

NPI number1417237728
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationSouthern Sports Medicine Institute, PLLC
Authorized official Thomas Gautsch — Owner · (615) 452-3320
NPI enumeratedAugust 18, 2011
Last updated in NPPESAugust 18, 2011
Mailing address570 Hartsville Pike, Gallatin, TN 37066-2450

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