Individual provider Active NPI

Gregory Bass, M.D.

  • Emergency Medicine Physician
  • Gloucester, VA
National Provider Identifier
1265457618
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101-221456 Issued in VA
Practice address
7519 Hospital Dr
Gloucester, VA 23061-4178
Phone
(804) 693-8800
NPI assigned
Jul 13, 2006
Last updated
May 30, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 044164 GA
Emergency Medicine Physician 207P00000X 0101-221456 VA Primary

Addresses

Primary practice location

7519 Hospital Dr
Gloucester, VA 23061-4178

Mailing address

5721 Kings Ridge Rd
Gloucester, VA 23061-4336
Phone (804) 695-0941

Other identifiers 1

IdentifierTypeStateIssuer
1265457618MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20070622000353 VA Practitioner - Emergency Medicine 8921107541 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
044164GAMDEmergency Medicine Physician
0101-221456VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Physician Services Inc CurrentSince May 14, 2007 Accepting new patients
Riverside Physician Services Inc Current Accepting new patients
Riverside Physician Services Inc Emergency Medicine CurrentSince May 14, 2007 Accepting new patients
Riverside Physician Services, Inc. Emergency Medicine Past Accepting new patients
Riverside Emergency Physicians LLP Emergency Medicine Past Accepting new patients

Locations

7519 Hospital Dr
Gloucester, VA 23061
Phone (804) 693-8800

1500 Commonwealth Ave
Williamsburg, VA 23185
Phone (757) 585-2200

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212105600000",
    "number": "1265457618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5721 KINGS RIDGE RD",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614336",
            "telephone_number": "804-695-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7519 HOSPITAL DR",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614178",
            "telephone_number": "804-693-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "GREGORY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2008-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "044164",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101-221456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265457618",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gloucester, VA

Sources for this page

Verify at the official NPI Registry.