Tamarra Bass

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

113 Creekridge Dr
Leesburg, GA 31763-7001

Phone

(229) 869-0795

NPI assigned

Mar 17, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tara Conner Bass Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1144805581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CORRIDOR RD UNIT 3929",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320047850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 CREEKRIDGE DR",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317637001",
            "telephone_number": "229-869-0795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "TAMARRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "BASS",
            "middle_name": "CONNER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• B.E. Active Fitness and Consulting, LLC
• Ildiko Babka, M.D.
• Back in Action Therapy Services
• Barry L Barker, DO
• Kevin Bass
• Orlandria Michelle Bennett-Reed
• Elisabeth Bennett, CTRS
• Robert L Bennett III
• Trebla Cole Bennett, LPC
• Bewell Integrative Health

• Behavior Technician in Leesburg, GA
• Providers in Leesburg, GA by specialty
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.