Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Augusta University

Organization Sports Medicine (Family Medicine) Physician · NPI 1215711155

Augusta University is a Sports Medicine (Family Medicine) Physician in Augusta, Georgia. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1120 15th St # B132
Augusta, GA 30912-0004
Phone: (972) 367-4845
Fax: (972) 367-3451
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X

Record details

NPI number1215711155
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Administrator/Agent · (972) 367-4845
Other names Augusta University Athletics
NPI enumeratedAugust 22, 2023
Last updated in NPPESAugust 22, 2023
Certification dateAugust 22, 2023
Mailing address15305 Dallas Pkwy Ste 800, Addison, TX 75001-6415

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