NPIMap

Organization Active NPI

Liberty University, Inc

Doing business as LUCS Sports Medicine

  • Sports Medicine (Family Medicine) Physician
  • Lynchburg, VA
National Provider Identifier
1689296360
Registry record updated May 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
LIBERTY UNIVERSITY, INC
Doing business as
LUCS Sports Medicine
Practice address
1971 University Blvd
Lynchburg, VA 24515-0002
Phone
(434) 582-2100
NPI assigned
May 15, 2020
Last updated
May 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2020

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

Authorized official

Name
Mouzon Bass III
Title
Administrator/Agent
Phone
(972) 367-4845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X NU Primary

Addresses

Primary practice location

1971 University Blvd
Lynchburg, VA 24515-0002

Mailing address

5050 Spring Valley Rd
Dallas, TX 75244-3995

Other names 1

  • LUCS Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Liberty 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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1689296360",
    "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": "1971 UNIVERSITY BLVD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245150002",
            "telephone_number": "434-582-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY UNIVERSITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "BASS",
        "authorized_official_first_name": "MOUZON",
        "authorized_official_title_or_position": "ADMINISTRATOR/AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LUCS Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynchburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.