Individual provider Active NPI

Marissa Barron Bass

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1811456932
Registry record updated Sep 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
92213 Issued in GA
Practice address
1001 Johnson Ferry Rd
Atlanta, GA 30342-1605
Phone
(404) 785-5437
NPI assigned
Mar 18, 2019
Last updated
Sep 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 92213 GA Primary

Addresses

Primary practice location

1001 Johnson Ferry Rd
Atlanta, GA 30342-1605

Mailing address

1001 Johnson Ferry Rd
Atlanta, GA 30342-1605
Phone (404) 785-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190717000846 GA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 7012242720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11498GAMDPharmacist
92213GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scottish Rite Children's Medical Center Past Accepting new patients
Scottish Rite Childrens Medical Ctr Past Accepting new patients

Organizations & group practices 2

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726876800000",
    "number": "1811456932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421605",
            "telephone_number": "404-785-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421605",
            "telephone_number": "404-785-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "MARISSA",
        "middle_name": "BARRON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2024-09-21",
        "certification_date": "2024-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "92213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.