Lindenwood University

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

2013027435 Issued in MO

Legal business name

LINDENWOOD UNIVERSITY

Doing business as

Lindenwood University Sports Medicine

Practice address

209 S Kingshighway St
Saint Charles, MO 63301-1693

Phone

(636) 949-2000

NPI assigned

Sep 1, 2016

Last updated

Sep 7, 2016By the provider in NPPES

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

Agent

Phone

(972) 367-4845

Specialties & licenses 1

Addresses

Other names 1

• Lindenwood University Sports Medicine Doing business as

Tax ID family

Lindenwood University2 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.

• Lindenwood University-Belleville

  dba Lindenwood University-Belleville Sports Medicine

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Belleville, IL
  • NPI 1316499155
  NPD tax ID

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1831646397",
    "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": "209 S KINGSHIGHWAY ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633011693",
            "telephone_number": "636-949-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDENWOOD UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-07",
        "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": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MO",
            "license": "2013027435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lindenwood University Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Life Restoration Counseling, LLC
• Lifetime Dental Care of Missouri, Richard Straus, D.M.D., P.C. (Zumbehl Dental Care)
• Lifetime Love & Care, LLC
• Heather Lilledahl, M.A., CCC-SLP, M.ED.
• Linden Lactation LLC (Linden Lactation)
• Petina Collier Lindsey, LCSW
• Charles M Linsenmeyer, M.D.
• James Linsin, PSY.D.
• Lisa Adams Counseling LLC
• Linda Smith Litschgi, LPC

• Orthopaedic Surgery Physician in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Orthopaedic Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.