LIBERTY UNIVERSITY, INC (NPI# 1750848644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750848644 |
| Entity Type | Organization |
| Organization Name | LIBERTY UNIVERSITY, INC |
| Other Organization Name | LIBERTY SPORTS MEDICINE |
| Practice Address |
1971 University Blvd Lynchburg VA 24515-0002 |
| Mailing Address |
5050 Spring Valley Rd Dallas TX 75244-3995 |
| Practice Telephone | 9723674845 |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-27 |
| Authorized Official Name | MOUZON BASS III (ADMINISTRATOR) |
| Authorized Official Telephone | 9723674845 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Liberty Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689296360 | Liberty University, Inc | Family Medicine | 1971 University Blvd, Lynchburg, VA 24515-0002 | 2020-05-15 |
| 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 |
| Street Address |
1971 UNIVERSITY BLVD |
| City | LYNCHBURG |
| State | VA |
| Zip Code | 24515-0002 |
| 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 |
| 1689296360 | Liberty University, Inc | Family Medicine | 1971 University Blvd, Lynchburg, VA 24515-0002 | 2020-05-15 |
| 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 |
| Find all providers in the same location | ||||
| 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 Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407465289 | Martine H Long | General Practice | 515 Cornerstone St, Lynchburg, VA 24502-5342 | 2020-07-28 |
| 1942396908 | Wiggington Road Family Practice Inc | General Practice | 113 Wiggington Road, Lynchburg, VA 24502 | 2006-10-05 |
| 1356366645 | Harb L Rank | General Practice | 113 Wiggington Rd, Lynchburg, VA 24502-4619 | 2006-07-13 |
| 1710345608 | David Barnes | General Practice | 3365 Lawyers Rd, Lynchburg, VA 24501-7166 | 2016-02-05 |
| 1205851581 | Alan M Podosek | General Practice | 113 Wiggington Rd, Lynchburg, VA 24502-4619 | 2006-07-13 |
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| 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.