Missouri Baptist University

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

MISSOURI BAPTIST UNIVERSITY

Doing business as

Missouri Baptist University Athletics

Practice address

1 College Park Dr
Saint Louis, MO 63141-8660

Phone

(972) 367-4845

NPI assigned

Mar 30, 2023

Last updated

Mar 30, 2023By 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

Mr. Mouzon Bass III

Title

Administrator

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• MISSOURI BAPTIST UNIVERSITY ATHLETICS Doing business as

Locations

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

{
    "created_epoch": "1680134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1275237406",
    "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 COLLEGE PARK DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418660",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI BAPTIST UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MISSOURI BAPTIST UNIVERSITY ATHLETICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Missouri Baptist Medical Center
• Missouri Baptist Medical Center
• Missouri Baptist Medical Center
• Missouri Baptist Medical Center
• Missouri Baptist Physician Services LLC
• Missouri Bone & Joint Center
• Missouri Care, Inc. (Healthy Blue)
• Missouri Care, Inc.
• Missouri Caris Healthcare LLC
• Missouri Center for Orthopedics and Advanced Sports Medicine, LLC

• Sports Medicine (Family Medicine) Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Sports Medicine (Family Medicine) Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.