Mary Jaclyn Bassett, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT26267 Issued in FL

Practice address

1887 Kingsley Ave
Orange Park, FL 32073-4416

Phone

(904) 639-2715

Fax

(904) 639-7636

NPI assigned

Aug 9, 2022

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)

Enrolled

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1629706650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "383 WINDSWEPT WAY",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320923146",
            "telephone_number": "904-302-3663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1887 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734416",
            "telephone_number": "904-639-2715",
            "fax_number": "904-639-7636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSETT",
        "first_name": "MARY JACLYN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT26267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Floriano Bartolino, MS
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• Samantha Batteh, MD
• Sofia Alejandra Battistini Garcia, M.D.
• Courtney Batykefer
• Meagan Elizabeth Bauer, DMD
• Narciso Jebunan Bautista, PT

• Physical Therapist in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.