Bushnell University

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

Legal business name

BUSHNELL UNIVERSITY

Practice address

828 E 11TH Ave
Eugene, OR 97401-3745

Phone

(541) 684-7351

Fax

(972) 367-3451

NPI assigned

Aug 11, 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

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• Northwest Christian University Former legal business name

Locations

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1487020640",
    "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": "972-367-4845",
            "fax_number": "972-367-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 E 11TH AVE",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974013745",
            "telephone_number": "541-684-7351",
            "fax_number": "972-367-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUSHNELL UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-11",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Christian University",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Lisa Lynn Burtraw, L.M.T.
• Tiffany Megan Burwell
• Marie A Buscemi, MD
• Lauren Grace Buse, DNP, APRN-NP, FNP-C
• Allison Brooke Bushey
• Jedanndrila Bushnell
• Ashleigh Danielle Buss
• Nicole Busse
• Daniel Bussey
• Robert J Bustamante

• Pediatric Sports Medicine Physician in Eugene, OR
• Providers in Eugene, OR by specialty
• Pediatric Sports Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2020; 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.