Salve Regina University

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

15220 Issued in RI

Legal business name

SALVE REGINA UNIVERSITY

Doing business as

Salve Regina Sports Medicine

Practice address

100 Ochre Point Ave
Newport, RI 02840-4149

Phone

(972) 367-4845

NPI assigned

Sep 8, 2017

Last updated

Dec 17, 2021By 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

• Salve Regina Sports Medicine Doing business as

Tax ID family

Salve Regina 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.

• Salve Regina University

  • Student Health Clinic/Center
  • Newport, RI
  • NPI 1740468974
  NPD tax ID

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

{
    "created_epoch": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1881112027",
    "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": "100 OCHRE POINT AVE",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028404149",
            "telephone_number": "972-367-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALVE REGINA UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-08",
        "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": "AGENT",
        "authorized_official_telephone_number": "972-367-4845",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "RI",
            "license": "15220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Salve Regina Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Ida Saboya, LICSW, ABD
• James Safford, D.D.S
• Danielle Saldin, D.O.
• John Louis Salomone, DDS
• Salve Regina University
• Harold A Sanders, MD
• Sufala Patil Sapers, M.D.
• Arnold A. Sarazen, M.D.
• Melanie Saunders, DOULA
• Jared P Sauve, MPT

• Sports Medicine (Family Medicine) Physician in Newport, RI
• Providers in Newport, RI by specialty
• Sports Medicine (Family Medicine) Physician in Rhode Island

• 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.