Salome Mboh Basebang

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP142942 Issued in TX

Practice address

629 N Town East Blvd Apt 120
Mesquite, TX 75150-8342

Phone

(214) 325-0716

NPI assigned

Apr 27, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, WA, MI, CA4 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 4

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863
  Medicare reassignment NPD
• Vpa of Texas PLLC

  • Family Medicine Physician
  • Irving, TX
  • NPI 1679510499
  Medicare reassignment NPD
• Central Health Plan of California, Inc.

  • Health Maintenance Organization
  • Diamond Bar, CA
  • NPI 1386714772
  Medicare reassignment NPD
• Harmonycares Complete Health Services, PLLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1093543902

  TX

  Medicare reassignment NPD
• Molina Care Connections, LLC.

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223

  MI, TX

  Medicare reassignment NPD
• Molina Healthcare of California

  • Health Maintenance Organization
  • Long Beach, CA
  • NPI 1194811760
  Medicare reassignment NPD
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Everett, WA
  • NPI 1912235060
  Medicare reassignment NPD
• Open-Heart Palliative Hospice LLC

  • Community Based Hospice Care Agency
  • Houston, TX
  • NPI 1336837970
  NPD (past) Authorized official
• Molina Healthcare of Washington, Inc

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1659897163
  NPD
• Universal Care

  • Pediatrics Physician
  • Long Beach, CA
  • NPI 1376632877
  NPD

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

{
    "created_epoch": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1346738010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 N TOWN EAST BLVD APT 120",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751508342",
            "telephone_number": "214-325-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 N TOWN EAST BLVD APT 120",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751508342",
            "telephone_number": "214-325-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASEBANG",
        "first_name": "SALOME",
        "middle_name": "MBOH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "825443",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24331856",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corretta Danielle Barnes, NP
• Barry & Bright Healthcare Services Inc
• Sheila Katherine Bartley, OTR
• Lutfi Basatneh, M.D.
• Rami Basatneh, D.P.M.
• Bassam J Zakhour MD PA
• Rosanna Joyce Melo Battad
• Lindsey Bautzer
• Baylor Medical Center at Garland
• Bayside Dental Mesquite

• Family Nurse Practitioner in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2020; 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.