Basso Family LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

BASSO FAMILY LLC

Practice address

2821 N Ballas Rd Ste C15
Saint Louis, MO 63131-2300

Phone

(314) 394-8580

Fax

(314) 983-9650

NPI assigned

Apr 30, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Kipp Basso, DPMNPI 1295191112

Title

Chief Officer

Phone

(618) 578-8667

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IL2 enrollments

Enrollment records 2

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas Basso, DPM

  • Foot & Ankle Surgery Podiatrist
  • Saint Louis, MO
  • NPI 1295191112

  IL

  Medicare reassignment NPD Authorized official
• Philip Chu, MD

  • Internal Medicine Physician
  • Swansea, IL
  • NPI 1396797841
  NPD
• Mounir Shenouda, MD

  • Internal Medicine Physician
  • Swansea, IL
  • NPI 1235180043
  NPD
• Lawrence J. Barnes, PA-C

  • Medical Physician Assistant
  • O Fallon, IL
  • NPI 1184685174
  NPD (past)
• Dhawesuk Tang, MD

  • Internal Medicine Physician
  • Fairview Heights, IL
  • NPI 1508817321
  NPD (past)

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

{
    "created_epoch": "1651276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1245975614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 ENDICOTT CT",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622268210",
            "telephone_number": "618-578-8667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 N BALLAS RD STE C15",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312300",
            "telephone_number": "314-394-8580",
            "fax_number": "314-983-9650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "331 Salem Pl Ste 100",
            "address_purpose": "LOCATION",
            "city": "Fairview Heights",
            "state": "IL",
            "postal_code": "622081340",
            "country_code": "US",
            "telephone_number": "314-394-8580",
            "fax_number": "314-983-9650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BASSO FAMILY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-30",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "BASSO",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "KIPP",
        "authorized_official_title_or_position": "CHIEF OFFICER",
        "authorized_official_telephone_number": "618-578-8667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy B. Bassett, L.C.S.W.
• Margaret Bassi, OT
• Sherry R. Bassi, PH.D.
• Nazem Kaissar Bassil, M.D,
• Donald Robert Bassman, MD
• Douglas Basso, DPM
• Carolyn Hoffmeyer Bast, PHARMD
• Jacob Bast
• Kenneth John Bast, PHARMD
• Bahar Bastani, MD

• Podiatrist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Podiatrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.