Jennifer Emily Bass, COTA/L

Primary specialty

SpecialistTaxonomy code 174400000X

License

TA2283 Issued in MS

Practice address

275 Morning View Lane
Mantachie, MS 38855-7096

Phone

(662) 255-0161

NPI assigned

Sep 17, 2010

Last updated

Sep 17, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284681600000",
    "number": "1497063085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 MORNINGVIEW LN",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "388557096",
            "telephone_number": "662-255-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 MORNING VIEW LANE",
            "city": "MANTACHIE",
            "state": "MS",
            "postal_code": "388557096",
            "telephone_number": "662-255-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "JENNIFER",
        "middle_name": "EMILY",
        "name_prefix": "Ms.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-17",
        "last_updated": "2010-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "TA2283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timmi Unger Bishop, MS, RD, LD
• Austin Harbor Black, FNP-BC
• Hannah Grace Boren, FNP-C
• Andrea Carpenter, FNP-C
• Madison Leigh Carrell, FNP-C

• Specialist in Mantachie, MS
• Providers in Mantachie, MS by specialty
• Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.

Verify at the official NPI Registry.