University of North Carolina at Pembroke

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

UNIVERSITY OF NORTH CAROLINA AT PEMBROKE

Doing business as

UNCP Sports Medicine

Practice address

1 University Rd
Pembroke, NC 28372-8699

Phone

(972) 367-4845

NPI assigned

Mar 20, 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 III

Title

Administrator

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• UNCP Sports Medicine Doing business as

Tax ID family

Uncp Sports Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• University of North Carolina at Pembroke Student Health Services

  • Nurse Practitioner
  • Pembroke, NC
  • NPI 1194282285
  NPD tax ID
• University of North Carolina at Pembroke Student Health Services

  • Adolescent Medicine (Family Medicine) Physician
  • Pembroke, NC
  • NPI 1356845309
  NPD tax ID

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521504000000",
    "number": "1639673155",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 UNIVERSITY RD",
            "city": "PEMBROKE",
            "state": "NC",
            "postal_code": "283728699",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF NORTH CAROLINA AT PEMBROKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-03-20",
        "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_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": "UNCP Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Trinity Urgent Care & Family Practice, PLLC
• TT&ML LLC
• Darcentia Turner
• United Care of North Carolina
• Unity (Unity Pharmacy)
• University of North Carolina at Pembroke Student Health Services
• University of North Carolina at Pembroke Student Health Services
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5489)
• Wal-Mart Stores, Inc (Vision Center 30-5489)
• Walgreen Co (Walgreens #16119)

• Orthopaedic Surgery Physician in Pembroke, NC
• Providers in Pembroke, NC by specialty
• Orthopaedic Surgery Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2018; 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.