QUEENS UNIVERSITY OF CHARLOTTE
NPI 1457986515
Family Medicine - Sports Medicine in Charlotte, NC

NPI Status: Active since March 10, 2020

Contact Information

1900 SELWYN AVE
CHARLOTTE, NC
ZIP 28274
Phone: (972) 367-4845

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  • Organization
  • Family Medicine
  • Sports Medicine
  • CLIA Number: 34D0869311
  • CLIA Cert. Type: School/Student Health Service
  • CLIA Exp. Date: 08-31-2026

About QUEENS UNIVERSITY OF CHARLOTTE

This page provides the complete NPI Profile along with additional information for Queens University Of Charlotte, a primary care provider established in Charlotte, North Carolina operating as a Family Medicine, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1457986515 assigned on March 2020. The practitioner's primary taxonomy code is 207QS0010X. The provider is registered as an organization and their NPI record was last updated 6 years ago. Queens University Of Charlotte operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mouzon Bass (Administrator/agent)

NPI
1457986515
Provider Name
QUEENS UNIVERSITY OF CHARLOTTE
Entity Type
Organization
Location Address
1900 SELWYN AVE CHARLOTTE, NC 28274
Location Phone
(972) 367-4845
Mailing Address
5050 SPRING VALLEY RD DALLAS, TX 75244
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-10-2020
Last Update Date
03-10-2020
Code Navigator

A primary care provider (PCP) like Queens University Of Charlotte sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine Sports Medicine

Taxonomy Code
207QS0010X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MOUZON BASS

Authorized Official Title
ADMINISTRATOR/AGENT
Authorized Official Phone
(972) 367-4845

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
34D0869311
Facility Type
School/Student Health Service
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
JILL O. PERRY
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Queens University Of Charlotte to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1457986515, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
7
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
8
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
5
Unchanged
Pos 9
1
Doubled → 2
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 9 → 18 → 9 6 → 12 → 3 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 1 + 0 + 7 + 1 + 8 + 8 + 1 + 2 + 5 + 2 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1457986515.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Specialist/Technologist (Athletic Trainer)
1900 SELWYN AVE, #421
CHARLOTTE, NC 28274
Community Health Worker
1900 SELWYN AVE
CHARLOTTE, NC 28274
Music Therapist
1900 SELWYN AVE, QUEENS UNIVERSITY OF CHARLOTTE
CHARLOTTE, NC 28274
Specialist/Technologist (Athletic Trainer)
1900 SELWYN AVE
CHARLOTTE, NC 28274
Physical Medicine & Rehabilitation (Sports Medicine)
1900 SELWYN AVE
CHARLOTTE, NC 28274
Music Therapist
1900 SELWYN AVE
CHARLOTTE, NC 28274
Counselor (Mental Health)
1900 SELWYN AVE
CHARLOTTE, NC 28274

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1457986515, enumerated as an "organization" on March 10, 2020.

The provider is located at 1900 SELWYN AVE CHARLOTTE, NC 28274 and the phone number is (972) 367-4845.

Family Medicine with taxonomy code 207QS0010X and a focus in Sports Medicine.