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CENTRAL STATE SPORTS MEDICINE
NPI 1508244641
Family Medicine in Wilberforce, OH

Active since May 08, 2015CLIA 36D0033865 · Microscopy
1400 BRUSH ROW RD, WILBERFORCE, OH 45384(937) 925-3748(972) 367-3451 Get Directions Write a Review

NPPES record last updated: May 8, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Central State Sports Medicine NPPES

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

CENTRAL STATE SPORTS MEDICINE (NPI 1508244641) is a healthcare organization registered as a family medicine in Wilberforce, Ohio and active in the NPI registry since May 2015. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Mouzon Bass, Agent, as its authorized official.

NPPES Registry Identity

NPI1508244641
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCENTRAL STATE UNIVERSITY
Location Address1400 BRUSH ROW RDWilberforce, OH 45384-5800
Mailing AddressPo Box 650850Dallas, TX 75265-0850 · (972) 367-4845 · Fax (972) 367-3451
Phone(937) 925-3748
Fax(972) 367-3451
Organization SubpartNo
Authorized OfficialMouzon BassAgent · (972) 367-4845
Enumeration DateMay 8, 2015
✔ NPI 1508244641 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedFamily Medicine · Sports MedicineTaxonomy 207QS0010X
1400 BRUSH ROW RD, Wilberforce, OH 45384
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Other Names 1

Doing Business AsCentral 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 for Provider-Performed Microscopy Procedures (PPMP) 36D0033865

Central State University Student Health Services · Wilberforce, OH
Active · expires Aug 31, 2026
CLIA Number36D0033865
Laboratory TypeSchool/Student Health Service
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorKaren M. Mathews
Laboratory Phone(937) 376-6134
Laboratory LocationCentral State University Student Health Services1400 Brush Row Road Health Center, Wilberforce, OH 45384
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

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

DR. KAREN MICHELLE MATHEWS MD
Family Medicine
1400 BRUSH ROW RD, CENTRAL STATE UNIVERSITY STUDENT HEALTH CENTER
WILBERFORCE, OH 45384
Greene County (937) 376-6076
JOHN BRIGHT ATC
Specialist/Technologist (Athletic Trainer)
1400 BRUSH ROW RD
WILBERFORCE, OH 45384
Greene County (937) 376-6130
MS. LASHAUNTA JONES AT, ATC
Specialist/Technologist (Athletic Trainer)
1400 BRUSH ROW RD
WILBERFORCE, OH 45384
Greene County (937) 376-6617
CONNIE SUE HELMUTH FNP
Nurse Practitioner (Family)
1400 BRUSH ROW RD
WILBERFORCE, OH 45384
Greene County (937) 376-6077

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 Central State University's NPI number?

The NPI number for Central State University is 1508244641. It was assigned to this organization in the NPPES registry on May 8, 2015. The provider is doing business as Central State Sports Medicine.

Where is Central State University located?

Central State University is located at 1400 Brush Row Rd, Wilberforce, OH 45384. The listed phone number is (937) 925-3748.

What is Central State University's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Central State University hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 36D0033865) is associated with this NPI, valid through August 31, 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 Central State University was last updated on May 8, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.