Kathy Denese Bass

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

NP-APRN11000137 Issued in FL

Practice address

PO Box 170
Interlachen, FL 32148-0170

Phone

(386) 684-0195

NPI assigned

Jun 7, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Island Doctors Intrastate LLC 74 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Island Doctors Intrastate LLC

  • Primary Care Clinic/Center
  • Saint Augustine, FL
  • NPI 1568083889

  FL

  Medicare reassignment Care Compare group NPD
• Desai Medical Center for Primary Care and Integrative Medicine PA

  • Primary Care Clinic/Center
  • Lady Lake, FL
  • NPI 1881831576

  FL

  Medicare reassignment NPD
• Pioneer Medical Group, PL

  • Internal Medicine Physician
  • Temple Terrace, FL
  • NPI 1710315775

  Acute Care, FL

  Medicare reassignment NPD
• Roy H Hinman MD PA

  • Family Medicine Physician
  • St Augustine, FL
  • NPI 1649383845

  FL

  Medicare reassignment NPD
• Lina L Feaster PA

  • Primary Care Clinic/Center
  • St Augustine, FL
  • NPI 1922205251
  NPD (past)

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1609435239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170",
            "city": "INTERLACHEN",
            "state": "FL",
            "postal_code": "321480170",
            "telephone_number": "386-684-0195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 170",
            "city": "INTERLACHEN",
            "state": "FL",
            "postal_code": "321480170",
            "telephone_number": "386-684-0195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 NW Commerce Dr",
            "address_purpose": "LOCATION",
            "city": "Lake City",
            "state": "FL",
            "postal_code": "320554709",
            "country_code": "US",
            "telephone_number": "800-507-8874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 NW Commerce Dr",
            "address_purpose": "LOCATION",
            "city": "Lake City",
            "state": "FL",
            "postal_code": "320554709",
            "country_code": "US",
            "telephone_number": "800-507-8874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASS",
        "first_name": "KATHY",
        "middle_name": "DENESE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "NP-APRN11000137",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "NP-APRN11000137",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anay Investments LLC
• Anay Investments LLC
• Jason David Anderson, OTR/L
• Michelle Anderson
• Sabrina Bair, LMT
• Victoria Brill, L.M.
• Nicolas Contreras, RPH
• Melisa T Crosby, PT
• Thomas Davis
• Ashley Ellison, APRN

• All providers in Interlachen, FL
• Acute Care Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.