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EDWARD WATERS UNIVERSITY
NPI 1609596592
Family Medicine - Sports Medicine in Jacksonville, FL

Active since August 31, 2022
1658 KINGS RD, JACKSONVILLE, FL 32209(972) 367-4845(972) 367-3451 Get Directions Write a Review

NPPES record last updated: August 31, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Edward Waters University NPPES

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

EDWARD WATERS UNIVERSITY (NPI 1609596592), doing business as Ewc Sports Medicine, is a healthcare organization registered as a sports medicine in Jacksonville, Florida and active in the NPI registry since August 2022. The organization lists Mouzon Bass, Ceo/administrator, as its authorized official.

NPPES Registry Identity

NPI1609596592
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameEDWARD WATERS UNIVERSITY
Location Address1658 KINGS RDJacksonville, FL 32209-6167
Mailing Address15305 Dallas Pkwy Ste 800Addison, TX 75001-6415 · (972) 367-4845 · Fax (972) 367-3451
Phone(972) 367-4845
Fax(972) 367-3451
Organization SubpartNo
Authorized OfficialMouzon BassCeo/administrator · (972) 367-4845
Enumeration DateAugust 31, 2022
NPPES CertifiedAugust 29, 2022
✔ NPI 1609596592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
Definition
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.
1658 KINGS RD, Jacksonville, FL 32209
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Other Names 1

Doing Business AsEwc 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

Other Providers at the Same Location NPPES 2

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

CAELAN WILLIAMS ATC
Specialist/Technologist (Athletic Trainer)
1658 KINGS RD
JACKSONVILLE, FL 32209
Duval County (904) 470-8000
W.B. STEWART TIGERS ATHLETICS BOOSTERS
Pediatrics (Adolescent Medicine)
1658 KINGS RD
JACKSONVILLE, FL 32209
Duval County (972) 367-4845

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 Edward Waters University's NPI number?

The NPI number for Edward Waters University is 1609596592. It was assigned to this organization in the NPPES registry on August 31, 2022. The provider is doing business as Ewc Sports Medicine.

Where is Edward Waters University located?

Edward Waters University is located at 1658 Kings Rd, Jacksonville, FL 32209. The listed phone number is (972) 367-4845.

What is Edward Waters University's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

When was this NPI record last updated?

The NPPES record for Edward Waters University was last updated on August 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.