Active NPI
Dallas Scott Basham, NP
- Nurse Practitioner
- Crestview Hills, KY
National Provider Identifier
1194758029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3003742
- Practice address
- 350 Thomas More Pkwy
Suite 160
Crestview Hills, KY 41017-5465 - Phone
- (513) 221-1100
- Fax
- (513) 569-5297
- NPI assigned
- Jul 7, 2006
- Last updated
- Mar 21, 2016
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | COA.06624-NP | OH | |
| Nurse Practitioner | 363L00000X | 3003742 | KY | Primary |
| Acute Care Nurse Practitioner | 363LA2100X | COA.06624-NP | OH | |
| Acute Care Nurse Practitioner | 363LA2100X | 3003742 | KY | |
| Registered Nurse | 163W00000X | RN.178465-1 | OH | |
| Registered Nurse | 163W00000X | 1097793 | KY |
Addresses
Primary practice location
350 Thomas More Pkwy
Suite 160
Crestview Hills, KY 41017-5465
Mailing address
PO Box 643398
Cincinnati, OH 45264-3398
Phone (513) 221-1100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2328734 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 93.01 of 100
- Quality
- 86.02
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1097793 | KY | MD | Registered Nurse |
| RN.178465-1 | OH | MD | Registered Nurse |
| COA.06624-NP | OH | MD | Acute Care Nurse Practitioner |
Interoperability endpoints
- sbasham@1241.direct.myezyaccess.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458518400000",
"number": "1194758029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 643398",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452643398",
"telephone_number": "513-221-1100",
"fax_number": "513-569-5297"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "350 THOMAS MORE PKWY",
"address_2": "SUITE 160",
"city": "CRESTVIEW HILLS",
"state": "KY",
"postal_code": "410175465",
"telephone_number": "513-221-1100",
"fax_number": "513-569-5297"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASHAM",
"first_name": "DALLAS",
"middle_name": "SCOTT",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2016-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "OH",
"license": "COA.06624-NP",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3003742",
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "OH",
"license": "COA.06624-NP",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "KY",
"license": "3003742",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN.178465-1",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "KY",
"license": "1097793",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2328734",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Crestview Hills, KY
- Brady Baker, PA-C
- Doris R. Bankston, PTA
- Krista Barnett, APRN
- Ruth Ellen Barone, MSN, APRN, FNP-BC
- Raymond Curtis Bartholomew III, M.ED. LPCC
- Beacon Orthopaedics & Sports Medicine, LTD
- Becker Neurological Institute PLLC
- Philip S. Becker, M.D.
- Beiting Family Dentistry
- Daniel Joseph Beiting Sr., D.M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.