Individual provider Active NPI

Derek Russell Bass, DO

  • Orthopaedic Surgery Physician
  • Columbus, GA
National Provider Identifier
1184201584
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
112152 Issued in GA
Practice address
6262 Veterans Pkwy
Columbus, GA 31909-3540
Phone
(706) 324-6661
NPI assigned
Mar 24, 2021
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

Verify at the official NPI Registry.