Bass Wellness LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

BASS WELLNESS LLC

Practice address

1180 6TH Ave FL 8
New York, NY 10036-8401

Phone

(917) 923-0569

Fax

(469) 414-5292

NPI assigned

Oct 24, 2022

Last updated

Oct 24, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Justin William Shaw, NP-P, PMHNP-BCNPI 1932611357

Title

Co-Founder

Phone

(917) 575-5662

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin William Shaw, NP-P, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Long Island City, NY
  • NPI 1932611357
  NPD Authorized official
• Melissa Joi Varda, MSN, RN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
  • NPI 1114693777
  NPD

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1578280293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FRANKLIN AVE APT 1B",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112053554",
            "telephone_number": "917-575-5662",
            "fax_number": "469-414-5292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 6TH AVE FL 8",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100368401",
            "telephone_number": "917-923-0569",
            "fax_number": "469-414-5292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASS WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-24",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "SHAW",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "CO-FOUNDER",
        "authorized_official_telephone_number": "917-575-5662",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP-P, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spyridon Panagiotis Basourakos, M.D.
• Mae Basow, PH.D.
• Sonia Basra
• Benjamin James Basri, LLP
• Bass Nurse Practitioners in Psychiatry PLLC (Bass Wellness Center)
• Helene Bass-Wichelhaus, PHD
• Adam J Bass, M.D.
• Adriana Sofia Bass
• Alan Bass, PH.D.
• Amy Bass, MD

• Psychiatric/Mental Health Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; 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.