Mary Ellen Bass, SPEECH THERAPIST

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA3409 Issued in FL

Practice address

255 SE 7TH Ave
Suite 2
Crystal River, FL 34429-4891

Phone

(352) 795-4117

Fax

(352) 563-2438

NPI assigned

Apr 26, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Central Florida Clinic for Rehabilitation

  • Rehabilitation Clinic/Center
  • Crystal River, FL
  • NPI 1225189525

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303776000000",
    "number": "1992096895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SE 7TH AVE",
            "address_2": "SUITE 2",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344294891",
            "telephone_number": "352-795-4117",
            "fax_number": "352-563-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 SE 7TH AVE",
            "address_2": "SUITE 2",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344294891",
            "telephone_number": "352-795-4117",
            "fax_number": "352-563-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASS",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "SPEECH THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-26",
        "last_updated": "2011-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA3409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH THERAPY LICIENCE",
            "identifier": "SA3406",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Lynn Bahner, CRNA
• Glendora Y Baker
• Richard Baker
• Ryte Baksiene, M.D.
• Barbara J Barfield, A.R.N.P
• Shauna L Baxter, LMT
• Bayside Orthotics LLC
• Catherine Bell
• Bella Sudore, PLLC
• Thomas F Bendowski, M.D.

• All providers in Crystal River, FL
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.