Patricia Rose Bast, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

82246 Issued in GA

Practice address

780 Canton Rd NE
Ste 200
Marietta, GA 30060

Phone

(770) 285-8026

NPI assigned

May 2, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Patricia Rose Bledsoe Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

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 and National Provider Directory roles.

• Lactation Consultants of Atlanta

  • Lactation Consultant (Registered Nurse)
  • Atlanta, GA
  • NPI 1144627746
  NPD (past)

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

{
    "created_epoch": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1710322896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 CANTON RD NE",
            "address_2": "STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-285-8026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 CANTON RD NE",
            "address_2": "STE 200",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30060",
            "telephone_number": "770-285-8026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Country Club Dr",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "30281",
            "country_code": "US",
            "telephone_number": "770-285-8026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "755 Mount Vernon Hwy NE Ste 430",
            "address_purpose": "LOCATION",
            "city": "Sandy Springs",
            "state": "GA",
            "postal_code": "303284279",
            "country_code": "US",
            "telephone_number": "770-285-8026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAST",
        "first_name": "PATRICIA",
        "middle_name": "ROSE",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-02",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A14128",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "82246",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "82246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIA",
            "last_name": "BLEDSOE",
            "middle_name": "ROSE",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Keren Aviva Bashan-Gilzenrat, M.D.
• Ronnie Bass
• Bonnie Ann Bassett, LPC, NCC
• Travis Bassett
• Shirley Ephraim Bassey, PA
• Victor J. Bateh, D.D.S.
• D Dionne Bates, LPC
• Jackson Bates, MD
• Jeffrey Michael Bates, D.C.
• Lucinda W. Bates, RPH

• Pediatrics Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.