Tennessee State University

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

TENNESSEE STATE UNIVERSITY

Doing business as

TSU Sports Medicine

Practice address

3500 John a Merritt Blvd
Nashville, TN 37209-1500

Phone

(571) 535-5979

Fax

(972) 367-3452

NPI assigned

Jun 2, 2015

Last updated

Jun 2, 2015By 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 3

Addresses

Other names 1

• TSU Sports Medicine Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433203200000",
    "number": "1912387226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650850",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752650850",
            "telephone_number": "800-555-9073",
            "fax_number": "972-367-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 JOHN A MERRITT BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091500",
            "telephone_number": "571-535-5979",
            "fax_number": "972-367-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNESSEE STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2015-06-02",
        "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": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TSU Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tennessee Spine & Sports Medecine, P.C.
• Tennessee Spine and Joint Center, P.C.
• Tennessee Spine and Nerve Institute, PC
• Tennessee Spine and Nerve Institute, PC
• Tennessee Sports Medicine, PC
• Tennessee Surgical PA Associates, PLLC
• Tennessee Telederm PLLC
• Tennessee Therapy Center, Inc
• Tennessee Therapy Centers, LLC
• Tennessee TMS Center, PLLC

• Orthopaedic Surgery Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Orthopaedic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.