University of Arkansas at Monticello

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

UNIVERSITY OF ARKANSAS AT MONTICELLO

Doing business as

UAM Sports Medicine

Practice address

663 University Drive
Monticello, AR 71656

Phone

(870) 460-1058

NPI assigned

Aug 9, 2019

Last updated

Aug 9, 2019By the provider in NPPES

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

• UAM Sports Medicine Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shellye Karen Byrd, ATC, LAT

  • Athletic Trainer
  • Monticello, AR
  • NPI 1639730401
  NPD

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1083269690",
    "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": "663 UNIVERSITY DRIVE",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "71656",
            "telephone_number": "870-460-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF ARKANSAS AT MONTICELLO",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "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": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UAM Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brooke Tucker
• Jeannie Rebecca Tucker, LCSW
• Christal Michelle Turner, MHPP
• Juanita B Turner, LMSW
• Lindsey Ray Tyson, PT
• Vera Lloyd Presbyterian Family Services, Inc.
• Emily Vickers, COTA
• Jennifer Elizabeth Vicknair, CRNA
• Amanda Vincent
• Walgreen Co (Walgreens #10666)

• General Practice Physician in Monticello, AR
• Providers in Monticello, AR by specialty
• General Practice Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.

Verify at the official NPI Registry.