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WEBER STATE UNIVERSITY
NPI 1053702431
Family Medicine - Sports Medicine in Ogden, UT

Active since February 06, 2015CLIA Certified · 2 labs
1001 UNIVERSITY CIR, OGDEN, UT 84408(972) 367-4845(972) 367-3451 Get Directions Write a Review

NPPES record last updated: December 17, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Dec 17, 2021, Jul 26, 2021, Dec 12, 2017 (3 updates tracked since 2017).

About Weber State University NPPES

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

WEBER STATE UNIVERSITY (NPI 1053702431) is a healthcare organization registered as a sports medicine in Ogden, Utah and active in the NPI registry since February 2015. The organization holds 2 active CLIA laboratory certificates and lists Mouzon Bass, Agent, as its authorized official.

NPPES Registry Identity

NPI1053702431
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameWEBER STATE UNIVERSITY
Location Address1001 UNIVERSITY CIROgden, UT 84408-5525
Mailing Address15305 Dallas Pkwy Ste 800Addison, TX 75001-6415 · (972) 367-4845
Phone(972) 367-4845
Fax(972) 367-3451
Organization SubpartNo
Authorized OfficialMouzon BassAgent · (972) 367-4845
Enumeration DateFebruary 6, 2015
Last NPPES UpdateDecember 17, 20213 updates tracked since enumeration
NPPES CertifiedDecember 17, 2021
✔ NPI 1053702431 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
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.
Also ListedFamily MedicineTaxonomy 207Q00000X
1001 UNIVERSITY CIR, Ogden, UT 84408
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D2115873

Weber State University Employee Wellness · Ogden, UT
Active · expires Jul 13, 2028
CLIA Number46D2115873
Laboratory TypeOnsite Corporate Wellness
Certificate Effective DateJuly 14, 2026
Certificate Expiration DateJuly 13, 2028
Laboratory DirectorRaeanna N. Johnson
Laboratory Phone(801) 626-6480
Laboratory LocationWeber State University Employee Wellness3650 Taylor Ave, Ogden, UT 84408
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 46D2194406

Weber State University Medical Laboratory Sciences · Ogden, UT
Active · expires Sep 29, 2026
CLIA Number46D2194406
Laboratory TypeUniversity
Certificate Effective DateSeptember 30, 2024
Certificate Expiration DateSeptember 29, 2026
Laboratory DirectorStephen D. Scharmann
Laboratory Phone(801) 626-6118
Laboratory LocationWeber State University Medical Laboratory SciencesMh 222 3875 Stadium Way Dept 3905, Ogden, UT 84408
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Weber State University's NPI number?

The NPI number for Weber State University is 1053702431. It was assigned to this organization in the NPPES registry on February 6, 2015.

Where is Weber State University located?

Weber State University is located at 1001 University Cir, Ogden, UT 84408. The listed phone number is (972) 367-4845.

What is Weber State University's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Does Weber State University hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Weber State University was last updated on December 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.