GLENVILLE STATE COLLEGE
NPI 1043850191
Internal Medicine - Sports Medicine in Glenville, WV

Q: What is Glenville State College's NPI number?

The NPI number for Glenville State College is 1043850191. It was assigned to this organization in the NPPES registry on January 7, 2020. The provider is doing business as Glenville Sports Medicine.

Q: What is Glenville State College's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Sports Medicine, with taxonomy code 207RS0010X.

Active since January 07, 2020

200 HIGH ST, GLENVILLE, WV 26351(972) 367-4845 Get Directions Write a Review

NPPES record last updated: January 7, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Glenville State College NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GLENVILLE STATE COLLEGE (NPI 1043850191), doing business as Glenville Sports Medicine, is a healthcare organization registered as a sports medicine in Glenville, West Virginia and active in the NPI registry since January 2020. The organization lists Mouzon Bass, Administrator/agent, as its authorized official.

NPPES Registry Identity

NPI1043850191

Entity TypeOrganization

Primary Taxonomy207RS0010X

Legal Business NameGLENVILLE STATE COLLEGE

Location Address200 HIGH STGlenville, WV 26351-1200

Mailing Address5050 Spring Valley RdDallas, TX 75244-3995

Phone(972) 367-4845

Organization SubpartNo

Authorized OfficialMouzon BassAdministrator/agent · (972) 367-4845

Enumeration DateJanuary 7, 2020

✔ NPI 1043850191 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207RS0010X

Definition

An internist 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 healthcare of the individual.

200 HIGH ST, Glenville, WV 26351

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Other Names 1

Doing Business AsGlenville Sports Medicine

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATELYNN MAMIE SMITH ATC

Specialist/Technologist (Athletic Trainer)