Snow College

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SNOW COLLEGE

Doing business as

Snow College Sports Medicine

Practice address

150 E. College Way
Ephraim, UT 84627

Phone

(800) 555-9073

Fax

(972) 367-3452

NPI assigned

Aug 18, 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, HANDY

Title

Agent

Phone

(972) 367-4845

Specialties & licenses 2

Addresses

Other names 1

• Snow College Sports Medicine Doing business as

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444348800000",
    "number": "1730555400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650850",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650850",
            "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": "150 E. COLLEGE WAY",
            "city": "EPHRAIM",
            "state": "UT",
            "postal_code": "84627",
            "telephone_number": "800-555-9073",
            "fax_number": "972-367-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNOW COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-10-09",
        "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",
        "authorized_official_credential": "HANDY"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Snow College Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Welby Scott, LPC
• Skyline Anesthesia
• Skyline Sports and Human Performance LLC
• Brenden Smith
• Kaitlyn Rose Abernethy Smith, ATC
• Alix Sorensen
• Katie Sterner
• Juliette M Stevens, CSW
• Morgan Stevens, MSWI
• Nathan Jared Strait, LCSW

• Family Medicine Physician in Ephraim, UT
• Providers in Ephraim, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2015; 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.