Individual provider Active NPI

Shakenna Bass, FNP-C

  • Nurse Practitioner
  • High Point, NC
National Provider Identifier
1730733080
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5012047 Issued in NC
Practice address
501 E Green Dr
High Point, NC 27260-6700
Phone
(336) 641-7688
NPI assigned
Jul 25, 2019
Last updated
Jul 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5012047 NC Primary

Addresses

Primary practice location

501 E Green Dr
High Point, NC 27260-6700

Mailing address

501 E Green Dr
High Point, NC 27260-6700
Phone (336) 641-7688

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20191014003544 NC Practitioner - Nurse Practitioner 5799016259 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Medical CenterGroup PAC ID 4789597477, 1,057 clinicians

Practice addresses (Care Compare)

1350 S Kings Dr
Charlotte, NC 28207-2134
Phone (704) 355-7328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Medical Center CurrentSince Oct 21, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 21, 2024 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 21, 2024 Accepting new patients
Carolinas Medical Center CurrentSince Oct 21, 2024 Accepting new patients
County of Guilford CurrentSince Aug 5, 2019 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients

Locations

1350 S Kings Dr
Charlotte, NC 28207
Phone (704) 446-1255

251 Eastway Dr
Charlotte, NC 28213
Phone (704) 446-9991

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

3311 Beam Rd
Ste 300A
Charlotte, NC 28217
Phone (704) 468-0137

1100 E Wendover Ave
Greensboro, NC 27405
Phone (336) 641-3245

1203 Maple St
Greensboro, NC 27405
Phone (336) 641-3896

501 E Green Dr
High Point, NC 27260
Phone (336) 641-7802

Interoperability endpoints

  • Direct secure messaging: sbass2948683@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1730733080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 E GREEN DR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272606700",
            "telephone_number": "336-641-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E GREEN DR",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272606700",
            "telephone_number": "336-641-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "SHAKENNA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-25",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5012047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

Verify at the official NPI Registry.