Individual provider Active NPI

Erica Lynn Basso, D.C.

  • Chiropractor
  • Roswell, GA
National Provider Identifier
1184902918
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR008844 Issued in GA
Practice address
1125 Woodstock Rd
Suite 340
Roswell, GA 30075-8220
Phone
(770) 990-2121
NPI assigned
Jul 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR008844 GA Primary

Addresses

Primary practice location

1125 Woodstock Rd
Suite 340
Roswell, GA 30075-8220

Mailing address

124 Chickasaw Run
Woodstock, GA 30188-1703
Phone (770) 990-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130104000035 GA Practitioner - Chiropractic 6204089048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12040 Etris Rd
D120
Roswell, GA 30075-8016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR008844GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
JPR Health, Inc. Chiropractor CurrentSince Dec 19, 2014 Accepting new patients

Locations

1125 Woodstock Rd
Ste 340
Roswell, GA 30075
Phone (770) 645-1880

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1184902918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 CHICKASAW RUN",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301881703",
            "telephone_number": "770-990-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 WOODSTOCK RD",
            "address_2": "SUITE 340",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300758220",
            "telephone_number": "770-990-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSO",
        "first_name": "ERICA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-27",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR008844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.