Ouachita Baptist University

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

OUACHITA BAPTIST UNIVERSITY

Practice address

410 Ouachita St
Arkadelphia, AR 71998-0001

Phone

(972) 367-4845

NPI assigned

Apr 30, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mouzon Bass

Title

Administrator

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• OBU Sports Medicine Doing business as

Tax ID family

Obu Sports Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ouachita Baptist University

  • Family Medicine Physician
  • Arkadelphia, AR
  • NPI 1821754334
  NPD tax ID

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1609364173",
    "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": "410 OUACHITA ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719980001",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUACHITA BAPTIST UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "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"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OBU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kierra Ogden
• Kimberly Ogle
• Jazmine S Oguinn
• Ralph Blair Olson, LPC, LMFT
• Kaylin Rose Orrell, MS, CF-SLP
• Ouachita Baptist University
• Ouachita Regional Counseling & Mental Health Center, Inc.
• Paige Denise Owen, PTA
• Keasha Owens, DPT
• Tanishia Owens

• Pediatrics Physician in Arkadelphia, AR
• Providers in Arkadelphia, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.