WILLIAM PENN SPORTS MEDICINE
NPI 1902314156
General Practice in Oskaloosa, IA

Q: What is William Penn University's NPI number?

The NPI number for William Penn University is 1902314156. It was assigned to this organization in the NPPES registry on January 22, 2018. The provider is doing business as William Penn Sports Medicine.

Q: What is William Penn University's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since January 22, 2018CLIA 16D2064096 · Waiver

201 TRUEBLOOD AVE, OSKALOOSA, IA 52577(972) 367-4845 Get Directions Write a Review

NPPES record last updated: January 22, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About William Penn Sports Medicine NPPES

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

WILLIAM PENN SPORTS MEDICINE (NPI 1902314156) is a healthcare organization registered as a general practice in Oskaloosa, Iowa and active in the NPI registry since January 2018. The organization holds a CLIA Waiver certificate valid through August 13, 2027 and lists Mouzon Bass, Administrator, as its authorized official.

NPPES Registry Identity

NPI1902314156

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameWILLIAM PENN UNIVERSITY

Location Address201 TRUEBLOOD AVEOskaloosa, IA 52577-1757

Mailing Address5050 Spring Valley RdDallas, TX 75244-3995

Phone(972) 367-4845

Organization SubpartNo

Authorized OfficialMouzon BassAdministrator · (972) 367-4845

Enumeration DateJanuary 22, 2018

✔ NPI 1902314156 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in IA · DO-05128

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

201 TRUEBLOOD AVE, Oskaloosa, IA 52577

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Other Names 1

Doing Business AsWilliam Penn 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 16D2064096

William Penn University Campus Health Clinic · Oskaloosa, IA

Active · expires Aug 13, 2027

CLIA Number16D2064096

Laboratory TypeSchool/Student Health Service

Certificate Effective DateAugust 14, 2025

Certificate Expiration DateAugust 13, 2027

Laboratory DirectorTimothy C. Schroeder

Laboratory Phone(641) 672-3328

Laboratory LocationWilliam Penn University Campus Health Clinic201 Trueblood Avenue, Oskaloosa, IA 52577

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 12

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

BRADEN ASHVIN PHETKHAMCHANH

Specialist/Technologist (Athletic Trainer)