Chandra Marie Basham, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD 27394 Issued in OR

Practice address

10535 NE Glisan St
Portland, OR 97220-4077

Phone

(503) 273-5142

NPI assigned

May 8, 2007

Last updated

Aug 8, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1316150022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22061",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972692061",
            "telephone_number": "503-659-1978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 NE GLISAN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972204077",
            "telephone_number": "503-273-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASHAM",
        "first_name": "CHANDRA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OR",
            "license": "MD27394",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "A97048",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD 27394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adela Theodora Basayne, M.A., L.M.T.
• Hilary R Basco, MD
• Thomas Arthur Base, D.M.D.
• Gina Nicole Bash, MD, PHD
• Jasper Coates Bash, MD
• Robert Bradley Basham, PH.D.
• Hillary Jayne Bashaw
• Fouzia Bashir, DENTAL HYGIENIST
• Basic Mindfulness Portland, LLC
• Shaunti Basil, PT, DPT

• Family Medicine Physician in Portland, OR
• Providers in Portland, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.