Active NPI
Derek Russell Bass, DO
- Orthopaedic Surgery Physician
- Columbus, GA
National Provider Identifier
1184201584
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 112152
- Practice address
- 6262 Veterans Pkwy
Columbus, GA 31909-3540 - Phone
- (706) 324-6661
- NPI assigned
- Mar 24, 2021
- Last updated
- Jul 9, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 4659 | AL | |
| Orthopaedic Surgery Physician | 207X00000X | 112152 | GA | Primary |
Addresses
Primary practice location
6262 Veterans Pkwy
Columbus, GA 31909-3540
Mailing address
PO Box 370
Fortson, GA 31808-0370
Phone (706) 494-3171
Other practice location 1
161 E University Dr
Auburn, AL 36832-6725
Phone (334) 826-2090
Other practice location 2
130 W Ravine Rd Ste 9C
Kingsport, TN 37660-3837
Phone (423) 224-3292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260626001107 | AL | Practitioner - Orthopedic Surgery | 6204309677 | |
| I20260626004102 | GA | Practitioner - Orthopedic Surgery | 6204309677 |
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 370
Fortson, GA 31808
PO Box
Suite 370
Fortson, GA 31808-0370
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783555200000",
"number": "1184201584",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 370",
"city": "FORTSON",
"state": "GA",
"postal_code": "318080370",
"telephone_number": "706-494-3171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6262 VETERANS PKWY",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319093540",
"telephone_number": "706-324-6661"
}
],
"practiceLocations": [
{
"address_1": "161 E University Dr",
"address_purpose": "LOCATION",
"city": "Auburn",
"state": "AL",
"postal_code": "368326725",
"country_code": "US",
"telephone_number": "334-826-2090",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "130 W Ravine Rd Ste 9C",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376603837",
"country_code": "US",
"telephone_number": "423-224-3292",
"fax_number": "423-224-3215",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BASS",
"first_name": "DEREK",
"middle_name": "RUSSELL",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-03-24",
"last_updated": "2026-07-09",
"certification_date": "2026-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "AL",
"license": "4659",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "GA",
"license": "112152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.