Kimberly A Bass, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A2625 Issued in NC

Practice address

8025 Creedmoor Rd Ste 200
Raleigh, NC 27613-4483

Phone

(919) 846-1018

Fax

(919) 846-5958

NPI assigned

Apr 21, 2020

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

• Ms. Kimberly A Hagen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Well Care Home Health of the Triangle

  • Home Health Agency
  • Raleigh, NC
  • NPI 1811998990
  NPD (past)

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1144840018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 611",
            "city": "STANTONSBURG",
            "state": "NC",
            "postal_code": "278830611",
            "telephone_number": "252-238-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8025 CREEDMOOR RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276134483",
            "telephone_number": "919-846-1018",
            "fax_number": "919-846-5958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-21",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A2625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "HAGEN",
            "middle_name": "A",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adeyosola Bass
• Brian Edmond Bass, MD
• Candace Bass
• Cindy H Bass, FNP
• Jerald Franklin Bass Jr.
• Maura Carter Bass, PA-C
• Olivia Brooke Bass
• Samuel Scott Bass, MS, MDIV, LMFT
• Theresa Bass, BS
• Surabhi Bassin, PT

• Physical Therapy Assistant in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.