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ALABAMA STATE SPORTS MEDICINE
NPI 1205356938
Orthopaedic Surgery - Sports Medicine in Montgomery, AL

Active since June 23, 2017CLIA 01D2132019 · Waiver
915 S JACKSON ST, MONTGOMERY, AL 36104(972) 367-4845 Get Directions Write a Review

NPPES record last updated: June 23, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Alabama State Sports Medicine NPPES

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

ALABAMA STATE SPORTS MEDICINE (NPI 1205356938) is a healthcare organization registered as a sports medicine in Montgomery, Alabama and active in the NPI registry since June 2017. The organization holds a CLIA Waiver certificate valid through June 8, 2027 and lists Mouzon Bass, Agent, as its authorized official.

NPPES Registry Identity

NPI1205356938
Entity TypeOrganization
Primary Taxonomy207XX0005X
Legal Business NameALABAMA STATE UNIVERSITY
Location Address915 S JACKSON STMontgomery, AL 36104-5716
Mailing Address5050 Spring Valley RdDallas, TX 75244-3995
Phone(972) 367-4845
Organization SubpartNo
Authorized OfficialMouzon BassAgent · (972) 367-4845
Enumeration DateJune 23, 2017
✔ NPI 1205356938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in AL · 32588
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
915 S JACKSON ST, Montgomery, AL 36104
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Other Names 1

Doing Business AsAlabama State 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 01D2132019

Alabama State University Health Center · Montgomery, AL
Active · expires Jun 8, 2027
CLIA Number01D2132019
Laboratory TypeCollege Health Center
Certificate Effective DateJune 9, 2025
Certificate Expiration DateJune 8, 2027
Laboratory DirectorJoyce Loyd-Davis Crnp
Laboratory Phone(334) 229-4438
Laboratory LocationAlabama State University Health Center915 S Jackson St Simpson Hall Ground Hall, Montgomery, AL 36104
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 12

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

CHRIS SCHEPEL
Specialist/Technologist (Athletic Trainer)
915 S JACKSON ST
MONTGOMERY, AL 36104
Montgomery County (334) 229-4182
COLLEEN CORNISH--FIGUEROA
Specialist/Technologist (Athletic Trainer)
915 S JACKSON ST
MONTGOMERY, AL 36104
Montgomery County (334) 229-4182
RACHEAL LAWLER ATC
Specialist/Technologist (Athletic Trainer)
915 S JACKSON ST
MONTGOMERY, AL 36104
Montgomery County (334) 229-4547
CODI SIMMONS MS, ATC
Specialist/Technologist (Athletic Trainer)
915 S JACKSON ST
MONTGOMERY, AL 36104
Montgomery County (254) 458-9378
MEGAN MARISA FOX
Specialist/Technologist (Athletic Trainer)
915 S JACKSON ST
MONTGOMERY, AL 36104
Montgomery County (704) 905-3803
MRS. GRESHUNDRIA MANIK RAINES OTR
Occupational Therapist
915 S JACKSON ST, ASU, DEPARTMENT OF OCCUPATIONAL THERAPY
MONTGOMERY, AL 36104
Montgomery County (334) 229-5602
LABRINA F JACKSON ATC, LAT
Specialist/Technologist (Athletic Trainer)
915 S JACKSON ST
MONTGOMERY, AL 36104
Montgomery County (334) 229-7627
DAQUILA WASHINGTON
Specialist/Technologist (Athletic Trainer)
915 S JACKSON ST
MONTGOMERY, AL 36104
Montgomery County (334) 229-4182

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 Alabama State University's NPI number?

The NPI number for Alabama State University is 1205356938. It was assigned to this organization in the NPPES registry on June 23, 2017. The provider is doing business as Alabama State Sports Medicine.

Where is Alabama State University located?

Alabama State University is located at 915 S Jackson St, Montgomery, AL 36104. The listed phone number is (972) 367-4845.

What is Alabama State University's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Does Alabama State University hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 01D2132019) is associated with this NPI, valid through June 8, 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 Alabama State University was last updated on June 23, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.