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Organization
BALL STATE UNIVERSITY
Active
Organization
BALL STATE UNIVERSITY
Active
Other names
Interprofessional Community Clinics, Ball State Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
BLAIR SCOTT MATTERN (ASSOCIATE DEAN FOR CLINICAL AFFAIRS)
(765) 285-5354
Entity
Organization
Contact information
Practice address
HB 155, MUNCIE, IN 47306-0001
(765) 285-4422
(765) 285-5623
Mailing address
2000 W UNIVERSITY AVE, MUNCIE, IN 47306-1022
(765) 285-5354
(765) 285-5623
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
231H00000X
Audiologist
—
NULL
231H00000X
Audiologist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
NULL
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/25/2014
Last updated
07/24/2026
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