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ALBANY STATE SPORTS MEDICINE
NPI 1598284408
Orthopaedic Surgery in Albany, GA

Active since September 12, 2017CLIA 11D1035000 · Waiver
504 COLLEGE DR, ALBANY, GA 31705(972) 367-4845 Get Directions Write a Review

NPPES record last updated: September 12, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Albany State Sports Medicine NPPES

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

ALBANY STATE SPORTS MEDICINE (NPI 1598284408) is a healthcare organization registered as an orthopaedic surgery in Albany, Georgia and active in the NPI registry since September 2017. The organization holds a CLIA Waiver certificate valid through December 19, 2026 and lists Mouzon Bass, Agent, as its authorized official.

NPPES Registry Identity

NPI1598284408
Entity TypeOrganization
Primary Taxonomy207X00000X
Legal Business NameALBANY STATE UNIVERSITY
Location Address504 COLLEGE DRAlbany, GA 31705-2717
Mailing Address5050 Spring Valley RdDallas, TX 75244-3995
Phone(972) 367-4845
Organization SubpartNo
Authorized OfficialMouzon BassAgent · (972) 367-4845
Enumeration DateSeptember 12, 2017
✔ NPI 1598284408 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in GA · 008291
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.
504 COLLEGE DR, Albany, GA 31705
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Other Names 1

Doing Business AsAlbany State Sports Medicine

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE 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 11D1035000

Albany State University Student Health Services · Albany, GA
Active · expires Dec 19, 2026
CLIA Number11D1035000
Laboratory TypeSchool/Student Health Service
Certificate Effective DateDecember 20, 2024
Certificate Expiration DateDecember 19, 2026
Laboratory DirectorDr. Vicki Phillips
Laboratory Phone(229) 430-4766
Laboratory LocationAlbany State University Student Health Services504 College Drive, Albany, GA 31705
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 13

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

JAZZMEN SHEREE MCCRAY
Student in an Organized Health Care Education/Training Program
504 COLLEGE DR
ALBANY, GA 31705
Dougherty County (770) 743-5835
NARDRIANA K LEWIS
Specialist/Technologist (Athletic Trainer)
504 COLLEGE DR
ALBANY, GA 31705
Dougherty County (229) 603-8929
MRS. NATALIE R THOMAS FNP-BC
Nurse Practitioner (Family)
504 COLLEGE DR, ACAD 138
ALBANY, GA 31705
Dougherty County (229) 430-4766
CAROL ANNE CONLEY BEST FNP-C
Nurse Practitioner (Family)
504 COLLEGE DR
ALBANY, GA 31705
Dougherty County (229) 500-2000
JONATHAN STEVEN WHITE ATC
Specialist/Technologist (Athletic Trainer)
504 COLLEGE DR
ALBANY, GA 31705
Dougherty County (229) 430-4600
QADRIYYAH TAHEERAH ALALIM NP
Family Medicine
504 COLLEGE DR
ALBANY, GA 31705
Dougherty County (229) 500-2329
MRS. REBECC MOHL BORER ATC
Physical Medicine & Rehabilitation (Sports Medicine)
504 COLLEGE DR
ALBANY, GA 31705
Dougherty County (229) 886-2268
KAMYA BRYANT
Student in an Organized Health Care Education/Training Program
504 COLLEGE DR
ALBANY, GA 31705
Dougherty County (229) 500-2000

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 Albany State University's NPI number?

The NPI number for Albany State University is 1598284408. It was assigned to this organization in the NPPES registry on September 12, 2017. The provider is doing business as Albany State Sports Medicine.

Where is Albany State University located?

Albany State University is located at 504 College Dr, Albany, GA 31705. The listed phone number is (972) 367-4845.

What is Albany State University's specialty?

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

Does Albany State University hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D1035000) is associated with this NPI, valid through December 19, 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 Albany State University was last updated on September 12, 2017. 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.