NORTHWEST COLLEGE ATHLETICS – Sports Medicine (Family Medicine) Physician, NPI 1417651183

NORTHWEST COLLEGE ATHLETICS is a healthcare provider. based in Addison, Texas. specializing in Sports Medicine (Family Medicine) Physician. The NPI Number for NORTHWEST COLLEGE ATHLETICS is 1417651183

Main info

Organization
Name
NORTHWEST COLLEGE ATHLETICS
NPI
1417651183
Phone
(972) 367-4845
Address
15305 DALLAS PKWY STE 800
Authorized Official
MR. MOUZON BASS III ADMINISTRATOR
Enumeration Date
28 March 2023
Last Update Date
28 March 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience21
Completeness80
Years active:3State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for NORTHWEST COLLEGE ATHLETICS

  • 15305 DALLAS PKWY STE 800

    ADDISON, TX 750016415

    Phone: (972) 367-4845

    Fax: (972) 367-3451

    Type: Mailing

  • 231 W 6TH ST BLDG 1

    POWELL, WY 824351898

    Phone: (972) 367-4845

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 75001)

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Frequently asked questions

Is NORTHWEST COLLEGE ATHLETICS listed with a National Provider Identifier?
Yes — NORTHWEST COLLEGE ATHLETICS has NPI 1417651183 on file in the registry.
Would NORTHWEST COLLEGE ATHLETICS appear as active to a payer?
You can treat NORTHWEST COLLEGE ATHLETICS as active for directory purposes; confirm clinical privileges separately.
How would a patient describe NORTHWEST COLLEGE ATHLETICS's focus?
For NORTHWEST COLLEGE ATHLETICS, the primary taxonomy reads as Sports Medicine (Family Medicine) Physician. Clinical services aligned with this taxonomy classification.
Is NORTHWEST COLLEGE ATHLETICS associated with Addison?
Public fields place NORTHWEST COLLEGE ATHLETICS around Addison, Texas. Always confirm the exact site before visiting.
Does NORTHWEST COLLEGE ATHLETICS accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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