Southern Virginia University

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

SOUTHERN VIRGINIA UNIVERSITY

Doing business as

SVU Sports Medicine

Practice address

1 University Hill Dr
Knight Sports Arena
Buena Vista, VA 24416-3038

Phone

(540) 261-4931

Fax

(540) 266-3866

NPI assigned

Sep 10, 2014

Organization subpart

No

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

Addresses

Other names 1

• SVU Sports Medicine Doing business as

Tax ID family

Southern Virginia University2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Southern Virginia University

  • Pediatric Allergy/Immunology Physician
  • Buena Vista, VA
  • NPI 1528654159
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suzanne Stevens Garcia, PA-C

  • Physician Assistant
  • Springfield, OR
  • NPI 1851452163
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1083015960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15305 DALLAS PKWY STE 800",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750016415",
            "telephone_number": "972-367-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY HILL DR",
            "address_2": "KNIGHT SPORTS ARENA",
            "city": "BUENA VISTA",
            "state": "VA",
            "postal_code": "244163038",
            "telephone_number": "540-261-4931",
            "fax_number": "540-266-3866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN VIRGINIA UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-10",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "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": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SVU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SVU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rockbridge County Board of Supervisors
• Rockbridge Midwifery Care, LLC
• Jerome E Rubbelke Jr., M.D.
• Sara D. Ruhlman, PT
• Burke W. Soffe, DMD
• Southern Virginia University
• Synergy Rehab and Wellness, Buena Vista
• Matthew Taylor, M.A., BCBA, LBA-V
• Therapy Associates, LLC
• Thomas F. Hamilton, MD, Inc

• Student Health Clinic/Center in Buena Vista, VA
• Providers in Buena Vista, VA by specialty
• Student Health Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.