Union College

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25858 Issued in KY

Legal business name

UNION COLLEGE

Doing business as

Union College Sports Medicine

Practice address

310 College St
Lakeside BLDG
Barbourville, KY 40906-1410

Phone

(972) 367-4845

NPI assigned

Feb 14, 2017

Last updated

Feb 14, 2017By 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

• Union College Sports Medicine Doing business as

Locations

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487030400000",
    "number": "1851830509",
    "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": "310 COLLEGE ST",
            "address_2": "LAKESIDE BLDG",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061410",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION COLLEGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-02-14",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "25858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Union College Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Playhouse Therapy Center, LLC
• Genevieve Marie Tomlinson, LCADC
• Thomas R Tribell Jr., TCADC
• Candice Goh Troxell, D.O.
• Angela Turner, APRN
• Cassie Renee Vaughn, PA-C
• Elizabeth Kate Vaughn, OTD
• Lesley N Vaughn, APRN
• William H. Vickers, O. D.
• Vora & Vora, P.S.C.

• Family Medicine Physician in Barbourville, KY
• Providers in Barbourville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2017; 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.