NPIMap

Organization Active NPI

Wingate University

Doing business as Wingate University Sports Medicine

  • Sports Medicine (Family Medicine) Physician
  • Wingate, NC
National Provider Identifier
1932586377
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
WINGATE UNIVERSITY
Doing business as
Wingate University Sports Medicine
Practice address
220 N Camden Rd
Wingate, NC 28174-9644
Phone
(972) 367-4845
Fax
(972) 367-3451
NPI assigned
May 6, 2015
Last updated
May 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Authorized official

Name
Mouzon Bass
Title
Agent
Phone
(972) 367-4845

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X NU Primary
Orthopaedic Surgery Physician 207X00000X NU

Addresses

Primary practice location

220 N Camden Rd
Wingate, NC 28174-9644

Mailing address

PO Box 650850
Dept 1011
Dallas, TX 75265-0850
Phone (800) 555-9073

Other names 1

  • Wingate University Sports Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wingate University6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1430870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430870400000",
    "number": "1932586377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650850",
            "address_2": "DEPT 1011",
            "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": "220 N CAMDEN RD",
            "city": "WINGATE",
            "state": "NC",
            "postal_code": "281749644",
            "telephone_number": "972-367-4845",
            "fax_number": "972-367-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINGATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-06",
        "last_updated": "2015-05-06",
        "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"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wingate University Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wingate, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.