NPIMap

Organization Active NPI

Winston-Salem State University

Doing business as WSSU Sports Medicine

  • Student Health Clinic/Center
  • Winston Salem, NC
National Provider Identifier
1144649948
Registry record updated Apr 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
WINSTON-SALEM STATE UNIVERSITY
Doing business as
WSSU Sports Medicine
Practice address
1250 S MLK Jr Dr
Winston Salem, NC 27107-1370
Phone
(336) 750-2597
NPI assigned
Apr 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Ian Mushinski, ATC, LAT
Title
Head Athletic Trainer
Phone
(336) 750-2597

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

1250 S MLK Jr Dr
Winston Salem, NC 27107-1370

Mailing address

5050 Spring Valley Rd
Dallas, TX 75244-3995
Phone (800) 555-9073

Other names 1

  • WSSU Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Winston-Salem State University4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1250 S Martin Luther King Jr Dr
Winston Salem, NC 27107
Phone (336) 750-2597

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397001600000",
    "number": "1144649948",
    "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",
            "telephone_number": "800-555-9073",
            "fax_number": "972-367-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 S MLK JR DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271071370",
            "telephone_number": "336-750-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINSTON-SALEM STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-04-09",
        "status": "A",
        "authorized_official_last_name": "MUSHINSKI",
        "authorized_official_first_name": "IAN",
        "authorized_official_title_or_position": "HEAD ATHLETIC TRAINER",
        "authorized_official_telephone_number": "336-750-2597",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ATC, LAT"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WSSU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; 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.