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CHRISTIAN BROTHERS UNIVERSITY
NPI 1063161156
Family Medicine - Sports Medicine in Memphis, TN

Active since March 23, 2022CLIA 44D2285519 · Waiver
650 E PARKWAY S, MEMPHIS, TN 38104(972) 367-4845 Get Directions Write a Review

NPPES record last updated: March 23, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Christian Brothers University NPPES

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

CHRISTIAN BROTHERS UNIVERSITY (NPI 1063161156), doing business as Christian Brothers University Athletics, is a healthcare organization registered as a sports medicine in Memphis, Tennessee and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through July 12, 2027 and lists Mouzon Bass, Administrator/agent, as its authorized official.

NPPES Registry Identity

NPI1063161156
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameCHRISTIAN BROTHERS UNIVERSITY
Location Address650 E PARKWAY SMemphis, TN 38104-5519
Mailing Address15305 Dallas Pkwy Ste 800Addison, TX 75001-6415 · (972) 367-4845
Phone(972) 367-4845
Organization SubpartNo
Authorized OfficialMouzon BassAdministrator/agent · (972) 367-4845
Enumeration DateMarch 23, 2022
NPPES CertifiedMarch 23, 2022
✔ NPI 1063161156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.
650 E PARKWAY S, Memphis, TN 38104
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Other Names 1

Doing Business AsChristian Brothers University Athletics

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

CLIA Laboratory Certificates CMS CLIA

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 44D2285519

Christian Brothers University Health Service · Memphis, TN
Active · expires Jul 12, 2027
CLIA Number44D2285519
Laboratory TypeSchool/Student Health Service
Certificate Effective DateJuly 13, 2025
Certificate Expiration DateJuly 12, 2027
Laboratory DirectorCsara Strong
Laboratory Phone(901) 218-0489
Laboratory LocationChristian Brothers University Health Service650 East Pkwy South Health Services, Roizer Center 100, Memphis, TN 38104
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

TYLER CUNNINGHAM PA
Physician Assistant
650 E PARKWAY S
MEMPHIS, TN 38104
Shelby County (901) 321-4122
GERMAN VASQUEZ PA-S, ARRT (MRI)
Physician Assistant
650 E PARKWAY S
MEMPHIS, TN 38104
Shelby County (870) 919-7738
VANESSA L SIMMONS PHYSICIAN ASSISTANT
Student in an Organized Health Care Education/Training Program
650 E PARKWAY S
MEMPHIS, TN 38104
Shelby County (210) 219-9647
MICHAEL CHRISTOPHER SOULT
Student in an Organized Health Care Education/Training Program
650 E PARKWAY S
MEMPHIS, TN 38104
Shelby County (901) 321-3388
TRAVIS M GIST
Physician Assistant
650 E PARKWAY S
MEMPHIS, TN 38104
Shelby County (901) 321-3000
DESHAIRA SAMPSON
Physician Assistant
650 E PARKWAY S
MEMPHIS, TN 38104
Shelby County (901) 785-2179
SHANNON SAMSA
Student in an Organized Health Care Education/Training Program
650 E PARKWAY S
MEMPHIS, TN 38104
Shelby County (901) 321-3000
RUBY BRIANNA WINTERS TLPC - MHSP
Counselor (Mental Health)
650 E PARKWAY S
MEMPHIS, TN 38104
Shelby County (901) 676-1919

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 Christian Brothers University's NPI number?

The NPI number for Christian Brothers University is 1063161156. It was assigned to this organization in the NPPES registry on March 23, 2022. The provider is doing business as Christian Brothers University Athletics.

Where is Christian Brothers University located?

Christian Brothers University is located at 650 E Parkway S, Memphis, TN 38104. The listed phone number is (972) 367-4845.

What is Christian Brothers University's specialty?

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

Does Christian Brothers University hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2285519) is associated with this NPI, valid through July 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Christian Brothers University was last updated on March 23, 2022. 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.