Individual provider Active NPI

Emmanuel Pierrot Bassil

  • Student in an Organized Health Care Education/Training Program
  • Jackson, MI
National Provider Identifier
1467198630
Registry record updated Jun 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
0116040561 Issued in VA
Practice address
205 N. East Avenue
Jackson, MI 49201
Phone
(517) 205-7147
NPI assigned
May 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116040561 VA Primary

Addresses

Primary practice location

205 N. East Avenue
Jackson, MI 49201

Mailing address

1215 Lee St Box 800133
Charlottesville, VA 22908-0816
Phone (434) 924-1984

Other practice location 1

1215 Lee St Box 80013
Charlottesville, VA 22908-0001
Phone (434) 924-1984

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
I20250717003949 VA Order and Referring Only - NephrologyPractitioner - Nephrology 6800302845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0116040561VAMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: ebassil791295@direct.hfhs.org
  • Direct secure messaging: ebassil674271@direct.healthsystem.virginia.edu

NPI Registry JSON

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749859200000",
    "number": "1467198630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST BOX 800133",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080816",
            "telephone_number": "434-924-1984",
            "fax_number": "434-244-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 N. EAST AVENUE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "49201",
            "telephone_number": "517-205-7147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St Box 80013",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080001",
            "country_code": "US",
            "telephone_number": "434-924-1984",
            "fax_number": "434-244-4502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASSIL",
        "first_name": "EMMANUEL",
        "middle_name": "PIERROT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-10",
        "last_updated": "2025-06-14",
        "certification_date": "2025-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116040561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.