Organization Active NPI

Bassett Family Chiropractic Inc

  • Chiropractor
  • Fort Walton Beach, FL
National Provider Identifier
1902841851
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0007652 Issued in FL
Legal business name
BASSETT FAMILY CHIROPRACTIC INC
Practice address
201 Florida PL SE
Fort Walton Beach, FL 32548-5812
Phone
(850) 301-0900
Fax
(850) 301-0606
NPI assigned
Jun 17, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Timothy M Bassett, D.C.NPI 1487696712
Title
President
Phone
(850) 301-0900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0007652 FL Primary

Addresses

Primary practice location

201 Florida PL SE
Fort Walton Beach, FL 32548-5812

Mailing address

201 Florida PL SE
Fort Walton Beach, FL 32548-5812
Phone (850) 301-0900

Other identifiers 1

IdentifierTypeStateIssuer
55835OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080422000370 FL Part B Supplier - Clinic/Group Practice 5193803815 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Walton Beach, FL

National Provider Directory

National Provider Directory

Locations

201 Florida Pl SE
Ft Walton Bch, FL 32548
Phone (850) 301-0900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902841851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 FLORIDA PL SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485812",
            "telephone_number": "850-301-0900",
            "fax_number": "850-301-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 FLORIDA PL SE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485812",
            "telephone_number": "850-301-0900",
            "fax_number": "850-301-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASSETT FAMILY CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BASSETT",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-301-0900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0007652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "55835",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.