University of West Georgia

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

UNIVERSITY OF WEST GEORGIA

Practice address

1601 Maple St
Carrollton, GA 30118-0001

Phone

(678) 839-6628

Fax

(972) 367-3451

NPI assigned

Jan 20, 2015

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

Agent

Phone

(800) 555-9073

Specialties & licenses 2

Addresses

Other names 1

• West georgia sports medicine Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Andrew M Bass, ATC

  • Athletic Trainer
  • Carrollton, GA
  • NPI 1225306210
  NPD (past)

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421712000000",
    "number": "1235528811",
    "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": "1601 MAPLE ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301180001",
            "telephone_number": "678-839-6628",
            "fax_number": "972-367-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF WEST GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-20",
        "last_updated": "2015-01-20",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "18005559073",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West georgia sports medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Twelve Gate Homehealthcare Services LLC
• Christy Tyson, OD
• Nnamdi Uhegwu, MD
• Bonnie Umberger
• United Rehab Inc.
• Linda Jean Urioste, CRNA
• Audrey Urquhart, FNP-C
• US Medclinic LLC
• Neha Vajpayee, M.D.
• Vanessa R Valdenegro Lopez, BCBA

• Family Medicine Physician in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.