Active NPI
Kassim Karl Bass
- Other Technician
- Orlando, FL
National Provider Identifier
1558876136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 3730 Gatlin Woods Dr
Orlando, FL 32812-7610 - Phone
- (855) 832-6727
- NPI assigned
- Dec 5, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Other Technician | 247200000X | FL | Primary |
Addresses
Primary practice location
3730 Gatlin Woods Dr
Orlando, FL 32812-7610
Mailing address
4575 SE Dixie Hwy
Stuart, FL 34997-6826
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524787200000",
"number": "1558876136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4575 SE DIXIE HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349976826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3730 GATLIN WOODS DR",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328127610",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASS",
"first_name": "KASSIM",
"middle_name": "KARL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-12-05",
"last_updated": "2018-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.