ETSU SPORTS MEDICINE – NPI #1285264531
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Health Care Provider Taxonomy Code for Family Medicine

ETSU SPORTS MEDICINE is a provider located in JOHNSON CITY, TN. NPPES has assigned the NPI number 1285264531 to ETSU SPORTS MEDICINE on January 24, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “ETSU SPORTS MEDICINE” is a dba name, the actual legal business name for this organization is EAST TENNESSEE STATE UNIVERSITY. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 4 years ago on Dec 17, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ETSU SPORTS MEDICINE below.

NPI Profile for
EAST TENNESSEE STATE UNIVERSITY

NPI Number
1285264531
Enumeration Date

(more than 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EAST TENNESSEE STATE UNIVERSITY
Doing Business As (dba): ETSU SPORTS MEDICINE
Primary location
1081 JOHN ROBERT BELL DR
RM W-127
JOHNSON CITY, TN 37614
Phone: (972) 367-4845 Fax:
Mailing address
15305 DALLAS PKWY STE 800
ADDISON, TX 75001-6415
Phone: (972) 367-4845 Fax:
Organization Subpart
No
Authorized Official
MOUZON BASS
ADMINISTRATOR/AGENT
Phone: (972) 367-4845
Updated
Certification Date
Dec 17, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.