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CLAYTON STATE SPORTS MEDICINE
NPI 1962891556
Family Medicine in Morrow, GA

Active since January 20, 2015
2000 CLAYTON STATE BLVD, MORROW, GA 30260(678) 466-4692(972) 367-3451 Get Directions Write a Review

NPPES record last updated: January 20, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Clayton State Sports Medicine NPPES

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

CLAYTON STATE SPORTS MEDICINE (NPI 1962891556) is a healthcare organization registered as a family medicine in Morrow, Georgia and active in the NPI registry since January 2015. The organization lists Mouzon Bass, Agent, as its authorized official.

NPPES Registry Identity

NPI1962891556
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameCLAYTON STATE UNIVERSITY
Location Address2000 CLAYTON STATE BLVDMorrow, GA 30260-1250
Mailing Address5050 Spring Valley RdDallas, TX 75244-3995 · (800) 555-9073 · Fax (972) 367-3452
Phone(678) 466-4692
Fax(972) 367-3451
Organization SubpartNo
Authorized OfficialMouzon BassAgent · 18005559073
Enumeration DateJanuary 20, 2015
✔ NPI 1962891556 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
2000 CLAYTON STATE BLVD, Morrow, GA 30260
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Other Names 1

Doing Business AsClayton 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

Other Providers at the Same Location NPPES 8

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

DANIELLE MASI ATC
Specialist/Technologist (Athletic Trainer)
2000 CLAYTON STATE BLVD
MORROW, GA 30260
Clayton County (678) 466-4688
BRITTANY LYNN DRAEGER
Nurse Practitioner (Family)
2000 CLAYTON STATE BLVD
MORROW, GA 30260
Clayton County (678) 466-4000
JASMIN LE
Specialist/Technologist (Athletic Trainer)
2000 CLAYTON STATE BLVD
MORROW, GA 30260
Clayton County (678) 466-4685
AUSTIN EPPLEY ATC
Specialist/Technologist (Athletic Trainer)
2000 CLAYTON STATE BLVD
MORROW, GA 30260
Clayton County (740) 819-8735
DR. NAQUILLA THOMAS RDH, EDD
Dental Hygienist
2000 CLAYTON STATE BLVD
MORROW, GA 30260
Clayton County (678) 466-4911
MARIA KINAS
Student in an Organized Health Care Education/Training Program
2000 CLAYTON STATE BLVD
MORROW, GA 30260
Clayton County (678) 466-4000
MINDY ANN SIMMONS MS, ATC, LAT, CSCS
Specialist/Technologist (Athletic Trainer)
2000 CLAYTON STATE BLVD, CLAYTON STATE ATHLETICS
MORROW, GA 30260
Clayton County (678) 466-4685
JULIA A SPINOLO DNP, APRN-BC
Nurse Practitioner (Family)
2000 CLAYTON STATE BLVD, SC 211 UHS
MORROW, GA 30260
Clayton County (678) 466-4941

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 Clayton State University's NPI number?

The NPI number for Clayton State University is 1962891556. It was assigned to this organization in the NPPES registry on January 20, 2015. The provider is doing business as Clayton State Sports Medicine.

Where is Clayton State University located?

Clayton State University is located at 2000 Clayton State Blvd, Morrow, GA 30260. The listed phone number is (678) 466-4692.

What is Clayton State University's specialty?

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

When was this NPI record last updated?

The NPPES record for Clayton State University was last updated on January 20, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.