Aly A. Bassal, M.D., F.I.C.S.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD0000013983 Issued in TN

Practice address

1000 W G St
Suite 104
Elizabethton, TN 37643-2959

Phone

(423) 543-4616

Fax

(423) 543-7771

NPI assigned

Jul 1, 2005

Last updated

Oct 5, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Aly A. Bassal Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1275530560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "address_2": "1000 WEST G STREET SUITE 104",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376440640",
            "telephone_number": "423-543-4616",
            "fax_number": "423-543-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W G ST",
            "address_2": "SUITE 104",
            "city": "ELIZABETHTON",
            "state": "TN",
            "postal_code": "376432959",
            "telephone_number": "423-543-4616",
            "fax_number": "423-543-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSAL",
        "first_name": "ALY",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D., F.I.C.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-01",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000013983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3191532",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALY",
            "last_name": "BASSAL",
            "middle_name": "A.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Shelby Anne Banner, PHARMD
• Amanda Lynn Barbrow
• Barnes Vision of Elizabethton
• Katie Barnett
• Dustin Robert Barrett, PT
• Amanda Sue Beach, APN
• April E Beam, R.N.
• Brian Timothy Benjamin, BS
• Vanessa Rae Bentley, RT(R)
• Sherrie Berry, APN

• Family Medicine Physician in Elizabethton, TN
• Providers in Elizabethton, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.