MARY KAY BASS (NPI# 1538240650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538240650 |
| Entity Type | Individual |
| Full Name | MARY KAY BASS |
| Credential | NP |
| Practice Address |
855 Montgomery St Dept of Ob/gyn Fort Worth TX 76107-2553 |
| Mailing Address |
Po Box 99335 Fort Worth TX 76199-0335 |
| Practice Telephone | 8179271065 |
| Practice Fax Number | 8179271065 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2011-09-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
426139 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 8N8816 | 01 |
| TX | 044360804 | 05 | |
| TX | RAILROAD MEDICARE | P00415573 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972882579 | Mary Louis Bass | Physical Therapist | 3505 Andover Ct, Bedford, TX 76021-2921 | 2011-08-12 |
| 1992096895 | Mary Ellen Bass | Speech-Language Pathologist | 255 Se 7th Ave, Suite 2, Crystal River, FL 34429-4891 | 2011-04-26 |
| 1740579697 | Mary Beth Bass | Nurse Practitioner | 2200 Childrens Way, Suite 3103, Nashville, TN 37232-2635 | 2011-03-31 |
| 1487776043 | Mary C Bass | Social Worker | 444 Sw Center St., Faison, NC 28341 | 2007-04-04 |
| 1902951718 | Mary Ellen Bass | Anesthesiology | 3949 Evans Ave, Fort Myers, FL 33901-9335 | 2007-01-24 |
| 1912913948 | Mary Phelps Bass | Nurse Anesthetist, Certified Registered | 1801 S 17th St, Wilmington, NC 28401-6443 | 2006-07-31 |
| 1336136175 | Mary Bass | Nurse Practitioner | 6151 S Yale Ave, Suite A-100, Tulsa, OK 74136-1907 | 2005-10-05 |
| Street Address |
855 MONTGOMERY ST DEPT OF OB/GYN |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76107-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831194455 | Patricia Lowrimore | Psychiatry & Neurology | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2005-06-20 |
| 1194353417 | Jason L Thompson | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-03-31 |
| 1639701808 | Tyrane Roberts-lagrone | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-02-06 |
| 1144860917 | Melissa Edwards Petersen | Clinical Neuropsychologist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2020-01-09 |
| 1629553813 | Lisa Jane Killam-worrall | Pharmacist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-10-03 |
| 1598250607 | Sima Taj Mozdbar | Optometrist | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-06-30 |
| 1588153993 | Kristen Reuter | Social Worker | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2018-05-02 |
| 1114431624 | Emily J. Clark | Counselor | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-11-20 |
| 1275073215 | Elizabeth Svyatoslavna Balyakina | Student in an Organized Health Care Education/Training Program | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-23 |
| 1588103659 | Frederick Olen Barnum Iv | Family Medicine | 855 Montgomery St, Fort Worth, TX 76107-2553 | 2017-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683602 | Renovo Wound and Hyperbarics Pllc | Emergency Medicine | 5668 Edwards Ranch Road, Suite 101, Fort Worth, TX 76107 | 2020-09-15 |
| 1669085437 | Ryan Bourgeois | Nurse Practitioner | 2917 Crocket Street, Fort Worth, TX 76107 | 2020-08-31 |
| 1053920546 | Christa Marie Widjaja | Optometrist | 1700 Montgomery St, Fort Worth, TX 76107 | 2020-07-30 |
| 1093351355 | Raymond Iannone | Pharmacist | 850 Montgomery St, Suite #310, Fort Worth, TX 76107 | 2019-11-21 |
| 1053963744 | Cumulus Injury Resolution, Inc. | Chiropractor | 4936 Byers Avenue, Fort Worth, TX 76107 | 2019-07-12 |
| 1770135576 | Shadia Osakwe | Physician Assistant | 855 Montgomery Street, Pediatric Clinic, Fort Worth, TX 76107 | 2019-07-11 |
| 1568945442 | Sachin P Patel | Physical Therapist | 4825 Wellesley St, Fort Worth, TX 76107 | 2018-09-07 |
| 1023594025 | Ftw Pharmacy Services Inc | Durable Medical Equipment & Medical Supplies | 2912 W 6th St Ste 150, Fort Worth, TX 76107 | 2018-07-13 |
| 1669974325 | Helen Williamson Elliott | Counselor | 1751 River Run #217, Fort Worth, TX 76107 | 2018-03-08 |
| 1487156931 | Pelvic Neuromonitoring Pllc | Electrodiagnostic Medicine | 111 Boland St #211, Ft Worth, TX 76107 | 2018-03-01 |
| Find all providers in zip 76107 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578929147 | Michelle Summerall | Nurse Practitioner | 1650 South Beach, Fort Worth, TX 76104 | 2016-01-12 |
| 1093734535 | Carla K Morrow | Nurse Practitioner | 622 Hemphill St, Fort Worth, TX 76104-3179 | 2006-07-18 |
| 1326030719 | Janice Maria Collins | Nurse Practitioner | 2900 Se Loop 820, Fort Worth, TX 76140-1013 | 2005-08-22 |
| 1528676400 | Kymberly Anett O'neal | Nurse Practitioner | 2900 Se Loop 820, Fort Worth, TX 76140-1013 | 2020-07-16 |
| 1073082533 | Abiena Cash | Nurse Practitioner | 2201 Se Loop 820, Fort Worth, TX 76119-5863 | 2018-11-14 |
| 1316457278 | Jamie Renee Shields | Nurse Practitioner | 2200 Ephriham Ave, Fort Worth, TX 76164-6642 | 2017-10-05 |
| 1235581372 | Sarah Elizabeth Clifford | Nurse Practitioner | 1500 S Main St, Fort Worth, TX 76104-4917 | 2016-07-12 |
| 1588076483 | Ann Palagi-pate | Nurse Practitioner | 1201 S Main St, Fort Worth, TX 76104-4804 | 2014-05-27 |
| 1508290057 | Carol Ann May | Nurse Practitioner | 855 Montgomery St, Dept of Ob/gyn, Fort Worth, TX 76107-2553 | 2013-09-02 |
| 1912217662 | Angela Mardine George | Nurse Practitioner | 4312 Heritage Trace Pkwy, Suite 700, Fort Worth, TX 76244-9132 | 2010-10-15 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76107 |
Please comment or provide details below to improve the information on MARY KAY BASS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.