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ECU SPORTS MEDICINE
NPI 1376038620
Orthopaedic Surgery in Ada, OK

Active since June 28, 2018CLIA 37D2200078 · Waiver

NPPES record last updated: June 28, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ecu Sports Medicine NPPES

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

ECU SPORTS MEDICINE (NPI 1376038620) is a healthcare organization registered as an orthopaedic surgery in Ada, Oklahoma and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through November 12, 2026 and lists Mouzon Bass, Administrator, as its authorized official.

NPPES Registry Identity

NPI1376038620
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameEAST CENTRAL UNIVERSITY
Location Address1100 E 14TH STAda, OK 74820-6915
Mailing Address5050 Spring Valley RdDallas, TX 75244-3995
Phone(972) 367-4845
Organization SubpartNo
Authorized OfficialMouzon BassAdministrator · (972) 367-4845
Enumeration DateJune 28, 2018
✔ NPI 1376038620 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
1100 E 14TH ST, Ada, OK 74820
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Other Names 1

Doing Business AsEcu 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 37D2200078

East Central University-Student Health Services · Ada, OK
Active · expires Nov 12, 2026
CLIA Number37D2200078
Laboratory TypeSchool/Student Health Service
Certificate Effective DateNovember 13, 2024
Certificate Expiration DateNovember 12, 2026
Laboratory DirectorLisa M. Letellier
Laboratory Phone(580) 559-5713
Laboratory LocationEast Central University-Student Health Services1100 East 14th St, Ada, OK 74820
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 10

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

TAMAMI IIDA
Specialist/Technologist (Athletic Trainer)
1100 E 14TH ST
ADA, OK 74820
Pontotoc County (580) 332-8000
LAUREN MICHELLE STAFFORD ATC
Specialist/Technologist (Athletic Trainer)
1100 E 14TH ST
ADA, OK 74820
Pontotoc County (580) 322-8000
MS. CAROL SUE SHORT
Behavior Analyst
1100 E 14TH ST
ADA, OK 74820
Pontotoc County (918) 426-5272
KYLE KINGREY ATC, LAT
Specialist/Technologist (Athletic Trainer)
1100 E 14TH ST
ADA, OK 74820
Pontotoc County (580) 559-5432
MISS RILEY RUSH A.T.C., L.A.T.
Specialist/Technologist (Athletic Trainer)
1100 E 14TH ST
ADA, OK 74820
Pontotoc County (580) 559-5532
DANIELLE ELIZABETH MCDARIS
Student in an Organized Health Care Education/Training Program
1100 E 14TH ST
ADA, OK 74820
Pontotoc County (580) 332-8000
JUDD ANDREW DRAKE
Specialist/Technologist (Athletic Trainer)
1100 E 14TH ST
ADA, OK 74820
Pontotoc County (870) 235-4000
MANUEL DAVID PENA ROSALES ATC, LAT
Specialist/Technologist (Athletic Trainer)
1100 E 14TH ST, PMB 4503
ADA, OK 74820
Pontotoc County (580) 279-4655

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 East Central University's NPI number?

The NPI number for East Central University is 1376038620. It was assigned to this organization in the NPPES registry on June 28, 2018. The provider is doing business as Ecu Sports Medicine.

Where is East Central University located?

East Central University is located at 1100 E 14th St, Ada, OK 74820. The listed phone number is (972) 367-4845.

What is East Central University's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Does East Central University hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2200078) is associated with this NPI, valid through November 12, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for East Central University was last updated on June 28, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.