Individual provider Active NPI

Jasmine Nicole Bass, FNP-C

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1124841903
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
249088 Issued in GA
Practice address
507 Bishop St NW Apt 2413
Atlanta, GA 30318-4482
Phone
(678) 358-8426
NPI assigned
Nov 1, 2024
Last updated
Nov 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 249088 GA Primary

Addresses

Primary practice location

507 Bishop St NW Apt 2413
Atlanta, GA 30318-4482

Mailing address

507 Bishop St NW Apt 2413
Atlanta, GA 30318-4482
Phone (678) 358-8426

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250205003060 GA Practitioner - Nurse Practitioner 3173053154 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
249088GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theramed Health, LLC CurrentSince Dec 23, 2024 Accepting new patients
Signify Health Medical Associates, PLLC Nurse Practitioner CurrentSince Jan 1, 2026 Accepting new patients

Locations

3950 Cobb Pkwy NW
Ste 401
Acworth, GA 30101
Phone (404) 857-9575

3250 Quick Water Lndg NW
Kennesaw, GA 30144
Phone (404) 857-9575

289 S Culver St
Lawrenceville, GA 30046
Phone (404) 458-0809

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1730419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1124841903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 BISHOP ST NW APT 2413",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303184482",
            "telephone_number": "678-358-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 BISHOP ST NW APT 2413",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303184482",
            "telephone_number": "678-358-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "JASMINE",
        "middle_name": "NICOLE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-01",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "249088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.