Edward Waters University
NPI 1609596592ActiveOrganization· Family Medicine, Sports Medicine· Jacksonville, FL
Family Medicine, Sports Medicine in Jacksonville, Florida, registered in NPPES in August 2022. The authorized official on file is Mouzon Bass, Ceo/Administrator.
Overview
| NPI | 1609596592 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Aug 31, 2022 |
| Last updated in NPPES | Aug 31, 2022 |
| Certified by provider | Aug 29, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine, Sports Medicine Primary | 207QS0010X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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