LIBERTY UNIVERSITY, INC


Address: 1971 University Blvd, Lynchburg, VA 24515-0002
Phone: 4345822100

LIBERTY UNIVERSITY, INC (NPI# 1689296360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689296360
Entity Type Organization
Organization Name LIBERTY UNIVERSITY, INC
Practice Address 1971 University Blvd
Lynchburg
VA 24515-0002
Mailing Address 5050 Spring Valley Rd
Dallas
TX 75244-3995
Practice Telephone 4345822100
Enumeration Date 2020-05-15
Last Update Date 2020-05-15
Authorized Official Name MOUZON BASS III (ADMINISTRATOR/AGENT)
Authorized Official Telephone 9723674845
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207QS0010X Family Medicine
Specialization: Sports Medicine
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
LUCS Sports Medicine Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1750848644 Liberty University, Inc General Practice 1971 University Blvd, Lynchburg, VA 24515-0002 2019-02-27

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations LIBERTY UNIVERSITY, INC. 1971 University Blvd, Lynchburg, VA 24515
Iowa Business Entities LIBERTY UNIVERSITY, INC. 1971 University Blvd, Lynchburg, VA 24515

Office Location

Street Address 1971 UNIVERSITY BLVD
City LYNCHBURG
State VA
Zip Code 24515-0002

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528056272 Richard Allan Lane Specialist 1971 University Blvd, Lynchburg, VA 24502-2269 2005-10-07
1619585361 Callie Bobo Specialist/Technologist 1971 University Blvd, Lynchburg, VA 24515-0002 2020-07-20
1386252187 Tanner Joseph Costine Specialist/Technologist 1971 University Blvd, Lynchburg, VA 24515-0002 2020-07-17
1760004576 Jackson Lohr Specialist/Technologist 1971 University Blvd, Lahaye Ice Center, Lynchburg, VA 24502 2020-05-14
1639705494 Madison Rose Mitchell Specialist/Technologist 1971 University Blvd, Lynchburg, VA 24515-0002 2020-03-12
1326688649 Joshua David Smith Specialist/Technologist 1971 University Blvd, Lynchburg, VA 24515-0002 2020-01-14
1629627807 Geordan Stapleton Dietitian, Registered 1971 University Blvd, Lynchburg, VA 24515-0002 2019-09-10
1144874611 Danielle Elizabeth Ferguson Dietitian, Registered 1971 University Blvd, Lynchburg, VA 24515 2019-08-01
1891347993 Alexander John Logwood Specialist/Technologist 1971 University Blvd, Lynchburg, VA 24515 2019-07-10
1770148025 Kaitlyn L Riggins Specialist/Technologist 1971 University Blvd, Lynchburg, VA 24515-0002 2019-05-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1174921852 Darlene Martin Specialist/Technologist 1971 University Blvd., Msc Box 710162, Liberty University, Dept of Public & Community Health, Lynchburg, VA 24515 2014-12-12
1114581774 Reed Worthington Specialist/Technologist Liberty University 1971 University Blvd, Lynchburg, VA 24515-0001 2019-04-29
1033600523 Noah Andrew Wilson Specialist/Technologist 1971 University Bld, Lynchburg, VA 24515-0001 2018-05-21
1265913123 Sukhwinder Kaur Pharmacist 1602 Regents Parkway, Lynchburg, VA 24515-0001 2018-08-28

Taxonomy Information

Taxonomy Code 207QS0010X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Sports Medicine

Taxonomy Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1487073482 Zdzislaw Victor Ratajczak Family Medicine 2405 Atherholt Rd, Lynchburg, VA 24501 2014-04-08
1174558472 Orthovirginia, Inc. Family Medicine 2405 Atherholt Rd, Lynchburg, VA 24501-2184 2006-07-12

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1326402116 Che Monte Torry Family Medicine 739 Thimble Shoals Blvd Ste 1008, Newport News, VA 23606-3585 2016-04-08
1063802890 Ferrum College Family Medicine 590 Ferrum Mountain Rd, Hank Norton Center, Ferrum, VA 24088 2015-02-02
1013174523 Kinjal Sohagia Family Medicine 732 Thimble Shoals Blvd Ste 803, Newport News, VA 23606-4218 2008-05-21
1396932323 Wellnessmd @ Acac LLC Family Medicine 406 Albemarle Sq, Charlottesville, VA 22901-1472 2007-10-03
1528261674 Jason Mchugh Family Medicine 2613 Taylor Rd Ste 100, Chesapeake, VA 23321-2246 2007-06-07
1073554713 Teresa Maria Camden Family Medicine 5211 W Broad St, 101, Richmond, VA 23230-3009 2006-06-10
1548237993 Delmas J Bolin Family Medicine 25 W Calhoun St, Salem, VA 24153-3836 2006-03-03
1245709088 Access Healthcare Multi-specialty Group, Pllc Family Medicine 2103 Graves Mill Rd, Forest, VA 24551-2675 2018-11-23
1124556352 Bluefield College Family Medicine 3000 College Ave, Bluefield, VA 24605-2050 2017-06-01
1295186377 Aaron S Ferro Family Medicine 7101 Jahnke Road, Mob #7175, Richmond, VA 23225 2016-06-29
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Competitor

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City LYNCHBURG
Zip Code 24515

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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