Individual provider Active NPI

Haley Jo Bassett, OTR

  • Occupational Therapy Assistant
  • Duluth, MN
National Provider Identifier
1639682776
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
105301 Issued in MN
Practice address
724 Maple Grove Rd
Duluth, MN 55811-4521
Phone
(218) 724-4900
Fax
(218) 722-3760
NPI assigned
Nov 12, 2017
Last updated
Sep 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 105301 MN Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

724 Maple Grove Rd
Duluth, MN 55811-4521

Mailing address

2538 Big Lake Rd
Cloquet, MN 55720-3300

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

State licenses

LicenseStateTypeSpecialty
105301MNMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1510444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1639682776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2538 BIG LAKE RD",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "557203300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "724 MAPLE GROVE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558114521",
            "telephone_number": "218-724-4900",
            "fax_number": "218-722-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSETT",
        "first_name": "HALEY",
        "middle_name": "JO",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-12",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "105301",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.