Hazel Nalyn Basa, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

32001575A Issued in IN

Practice address

2237 Engle Rd
Fort Wayne, IN 46809-1404

Phone

(260) 747-2353

NPI assigned

Dec 26, 2008

Last updated

Dec 26, 2008By 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

Practice roles

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

• Creative Health Solutions

  • Nursing Facility/Intermediate Care Facility
  • Marion, IN
  • NPI 1093979676
  NPD (past)

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

{
    "created_epoch": "1230249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230249600000",
    "number": "1609012582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N WABASH RD STE 200",
            "city": "MARION",
            "state": "IN",
            "postal_code": "469521300",
            "telephone_number": "765-651-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2237 ENGLE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468091404",
            "telephone_number": "260-747-2353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASA",
        "first_name": "HAZEL",
        "middle_name": "NALYN",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-26",
        "last_updated": "2008-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32001575A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Barto, RN
• Amber Bartock
• Matthew Tyler Bartock, D.O
• Lyric Barva-McCarty, RBT
• Kayla Bary, MA, BCBA
• Bradley S Basham, O.D.
• Carly Basham
• Devin Bashore, PHARMD
• Lutfullah Baskoy, MD
• Lacey Bass

• Occupational Therapy Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Occupational Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2008; 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.