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UNIVERSITY OF ARKANSAS AT MONTICELLO
NPI 1083269690
General Practice in Monticello, AR

Active since August 09, 2019CLIA 04D1073726 · Waiver
663 UNIVERSITY DRIVE, MONTICELLO, AR 71656(870) 460-1058 Get Directions Write a Review

NPPES record last updated: August 9, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About University Of Arkansas At Monticello NPPES

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

UNIVERSITY OF ARKANSAS AT MONTICELLO (NPI 1083269690), doing business as Uam Sports Medicine, is a healthcare organization registered as a general practice in Monticello, Arkansas and active in the NPI registry since August 2019. The organization holds a CLIA Waiver certificate valid through September 13, 2027 and lists Mouzon Bass, Administrator/agent, as its authorized official.

NPPES Registry Identity

NPI1083269690
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NameUNIVERSITY OF ARKANSAS AT MONTICELLO
Location Address663 UNIVERSITY DRIVEMonticello, AR 71656
Mailing Address5050 Spring Valley RdDallas, TX 75244-3995
Phone(870) 460-1058
Organization SubpartNo
Authorized OfficialMouzon BassAdministrator/agent · (972) 367-4845
Enumeration DateAugust 9, 2019
✔ NPI 1083269690 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
663 UNIVERSITY DRIVE, Monticello, AR 71656
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Other Names 1

Doing Business AsUam 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

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 04D1073726

University Of Arkansas At Monticello Student Health Services · Monticello, AR
Active · expires Sep 13, 2027
CLIA Number04D1073726
Laboratory TypeSchool/Student Health Service
Certificate Effective DateSeptember 14, 2025
Certificate Expiration DateSeptember 13, 2027
Laboratory DirectorTerri Richardson
Laboratory Phone(870) 460-1051
Laboratory LocationUniversity Of Arkansas At Monticello Student Health ServicesUniversity Center 517 University Drive, Monticello, AR 71656
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 University Of Arkansas At Monticello's NPI number?

The NPI number for University Of Arkansas At Monticello is 1083269690. It was assigned to this organization in the NPPES registry on August 9, 2019. The provider is doing business as UAM Sports Medicine.

Where is University Of Arkansas At Monticello located?

University Of Arkansas At Monticello is located at 663 University Drive, Monticello, AR 71656. The listed phone number is (870) 460-1058.

What is University Of Arkansas At Monticello's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Does University Of Arkansas At Monticello hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 04D1073726) is associated with this NPI, valid through September 13, 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 University Of Arkansas At Monticello was last updated on August 9, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.