# BALL STATE UNIVERSITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Interprofessional Community Clinics, Ball State Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295137925
- **Authorized official:** BLAIR SCOTT MATTERN (ASSOCIATE DEAN FOR CLINICAL AFFAIRS)
- **Authorized official phone:** (765) 285-5354

## Contact information

- **Practice address:** HB 155, MUNCIE, IN 47306-0001
- **Practice address phone:** (765) 285-4422
- **Practice address fax:** (765) 285-5623
- **Mailing address:** 2000 W UNIVERSITY AVE, MUNCIE, IN 47306-1022
- **Mailing address phone:** (765) 285-5354
- **Mailing address fax:** (765) 285-5623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | — | — | Yes |
| 231H00000X | Audiologist | — | NULL | — |
| 231H00000X | Audiologist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/25/2014
- **Last updated:** 07/24/2026