NPIMap

Organization Active NPI

Mercer University

Doing business as Mercer University Sports Medicine

  • Orthopaedic Surgery Physician
  • Macon, GA
National Provider Identifier
1740736024
Registry record updated Aug 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036295 Issued in GA
Legal business name
MERCER UNIVERSITY
Doing business as
Mercer University Sports Medicine
Practice address
1501 Mercer University Dr
Macon, GA 31207-1515
Phone
(478) 301-2994
NPI assigned
Aug 28, 2016
Last updated
Aug 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2016

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036295 GA Primary

Addresses

Primary practice location

1501 Mercer University Dr
Macon, GA 31207-1515

Mailing address

5050 Spring Valley Rd.
Dallas, TX 75244-3909

Other names 1

  • Mercer University Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Corporation of Mercer University8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1501 Mercer University Dr
Macon, GA 31207
Phone (478) 301-2600

NPI Registry JSON

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

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472342400000",
    "number": "1740736024",
    "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": "752443909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MERCER UNIVERSITY DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312071515",
            "telephone_number": "478-301-2994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCER UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "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"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "036295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercer University Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; 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.