Saginaw Valley State University

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

SAGINAW VALLEY STATE UNIVERSITY

Practice address

7400 Bay Rd
University Center, MI 48710-0001

Phone

(972) 367-4845

NPI assigned

Jul 26, 2021

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

Administrator by Agent

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• Saginaw Valley State University 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

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

{
    "created_epoch": "1627257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1548933740",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 BAY RD",
            "city": "UNIVERSITY CENTER",
            "state": "MI",
            "postal_code": "487100001",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGINAW VALLEY STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-26",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "ADMINISTRATOR BY AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saginaw Valley State University Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lindsey Minnich
• Jessica Pavwoski, FNP-C
• Casaundra Rochelle Perry, PTA
• Kayla Elizabeth Phillips, ATC
• Alyssa Pollard-McGrandy
• Stephanie Schulmeyer, AT, MS, ATC
• Bradley R Smith, MS, ATC
• Tiffany Rose Strickland
• Megan Vanvliet
• Mark Chipawnee-Allen West, ATC

• Orthopaedic Surgery Physician in University Center, MI
• Providers in University Center, MI by specialty
• Orthopaedic Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; 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.