Active NPI
Martha Ann Bass, PHYSICAL THERAPIST
- Contractor
- Anaheim, CA
National Provider Identifier
1336450436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- PT 7143
- Practice address
- 6210 E Twin Peak Cir
Anaheim, CA 92807-4848 - Phone
- (714) 974-5553
- Fax
- (714) 283-1896
- NPI assigned
- Jun 23, 2010
- Last updated
- Jun 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | PT 7143 | CA | Primary |
| Community Health Worker | 172V00000X | PT 7143 | CA |
Addresses
Primary practice location
6210 E Twin Peak Cir
Anaheim, CA 92807-4848
Mailing address
6210 E Twin Peak Cir
Anaheim, CA 92807-4848
Phone (714) 974-5553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 7143 | CA | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1336450436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6210 E TWIN PEAK CIR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928074848",
"telephone_number": "714-974-5553",
"fax_number": "714-283-1896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6210 E TWIN PEAK CIR",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928074848",
"telephone_number": "714-974-5553",
"fax_number": "714-283-1896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASS",
"first_name": "MARTHA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-23",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "CA",
"license": "PT 7143",
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "CA",
"license": "PT 7143",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.