NPI age
10 years
Enumerated 2015-08-10
● Active Type 2 · Organization
Fort Valley State University
Fort Valley State University is 1 of 5027 internal medicine organizations in Georgia.
Primary specialty
Internal Medicine
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Bass
Agent
Last NPPES update
2015-08-10
Source: monthly bulk 2026-05
How this organization compares
Across 5027 active internal medicine providers in Georgia.
NPI age
10 years
↓ 8 yr below median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 32% of peers with subspecialties
NPI lifetime · 2015 → 2026
2015-08Enumerated in NPPES
2015
2026
Where they practice
Primary practice location
1005 State University Dr
Fort Valley, GA 310304313
Mailing address
Po Box 650850
Dallas, TX 752650850
Authorized official
Mouzon Bass
Agent
📞 9723674845
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Crystal Small, ATC Specialist/Technologist NPI 1871618231
Specialties
-
Internal Medicine PrimaryA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
-
Internal MedicineAn internist trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
FVSUSports Medicine
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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