Active NPI
Mount Mercy University
- Orthopaedic Surgery Physician
- Cedar Rapids, IA
National Provider Identifier
1033770680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- Legal business name
- MOUNT MERCY UNIVERSITY
- Practice address
- 1330 Elmhurst Dr NE
Cedar Rapids, IA 52402-4763 - Phone
- (972) 367-4845
- NPI assigned
- Jun 25, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mouzon Bass III
- Title
- Administrator/Agent
- Phone
- (972) 367-4845
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | Primary |
Addresses
Primary practice location
1330 Elmhurst Dr NE
Cedar Rapids, IA 52402-4763
Mailing address
5050 Spring Valley Rd
Dallas, TX 75244-3995
Other names 1
- Mount Mercy Sports Medicine
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561420800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1573603200000",
"number": "1033770680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5050 SPRING VALLEY RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752443995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1330 ELMHURST DR NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524024763",
"telephone_number": "972-367-4845"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOUNT MERCY UNIVERSITY",
"organizational_subpart": "NO",
"enumeration_date": "2019-06-25",
"last_updated": "2019-11-13",
"status": "A",
"authorized_official_last_name": "BASS",
"authorized_official_first_name": "MOUZON",
"authorized_official_title_or_position": "ADMINISTRATOR/AGENT",
"authorized_official_telephone_number": "972-367-4845",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Mount Mercy Sports Medicine",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Mount Mercy Sports Medicine",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Cedar Rapids, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.