Northwest College

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

Legal business name

NORTHWEST COLLEGE

Doing business as

Northwest College Athletics

Practice address

231 W 6TH St BLDG 1
Powell, WY 82435-1898

Phone

(972) 367-4845

NPI assigned

Mar 28, 2023

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

• NORTHWEST COLLEGE ATHLETICS Doing business as

Locations

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1417651183",
    "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",
            "fax_number": "972-367-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 W 6TH ST BLDG 1",
            "city": "POWELL",
            "state": "WY",
            "postal_code": "824351898",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "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": "NORTHWEST COLLEGE ATHLETICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Karen Jean Nemitz, RN
• Quang T Nguyen, MD
• Spencer James Noble, DPT
• North Platte Physical Therapy Services Inc
• Bradley J North, DO
• Northwest Wyoming Treatment Center
• Brian P O'Neill, APRN
• Leif Ohman
• Tomasz Olejnik
• Taylor Olson, PHARMD

• Sports Medicine (Family Medicine) Physician in Powell, WY
• Providers in Powell, WY by specialty
• Sports Medicine (Family Medicine) Physician in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.