Ouachita Baptist University

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

OUACHITA BAPTIST UNIVERSITY

Doing business as

Ouachita Baptist University Health Services

Practice address

410 Ouachita St
Arkadelphia, AR 71998-0001

Phone

(972) 367-4845

NPI assigned

Nov 10, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Mouzon Bass III

Title

Administrator/Agent

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• Ouachita Baptist University Health Services 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

  dba OBU Sports Medicine

  • Pediatrics Physician
  • Arkadelphia, AR
  • NPI 1609364173
  NPD tax ID

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

{
    "created_epoch": "1636502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1821754334",
    "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": "2021-11-10",
        "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/AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ouachita Baptist University Health Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ouachita Baptist University Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Ogle
• Jazmine S Oguinn
• Ralph Blair Olson, LPC, LMFT
• Kaylin Rose Orrell, MS, CF-SLP
• Ouachita Baptist University (OBU Sports Medicine)
• Ouachita Regional Counseling & Mental Health Center, Inc. (Community Counseling Services, Inc.)
• Paige Denise Owen, PTA
• Keasha Owens, DPT
• Tanishia Owens
• Aliikai Kamea Pacheco

• Family Medicine Physician in Arkadelphia, AR
• Providers in Arkadelphia, AR by specialty
• Family Medicine 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.