MS. KENYA DEMETA BASS (NPI# 1942387485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942387485 |
| Entity Type | Individual |
| Full Name | MS. KENYA DEMETA BASS |
| Credential | PA-C |
| Practice Address |
1905 Skibo Rd Ste 100 Fayetteville NC 28314-0261 |
| Practice Telephone | 9108644357 |
| Practice Fax Number | 9102210099 |
| Mailing Telephone | 9108644357 |
| Mailing Fax Number | 9102210099 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2019-06-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 103419 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
103419 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1942387485 | 05 |
| Street Address |
1905 SKIBO RD STE 100 |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28314-0261 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629055918 | Damon Kimmery Arrington | Family Medicine | 1905 Skibo Rd Ste 100, Fayetteville, NC 28314-0261 | 2005-12-28 |
| 1023654068 | Cora Shante King | Nurse Practitioner | 1905 Skibo Rd Ste 100, Fayetteville, NC 28314-0261 | 2019-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528677812 | Lamonica Laveta Greene | Massage Therapist | 7804 Loxley Drive, Fayetteville, NC 28314 | 2020-07-23 |
| 1467086496 | The Pair Center for Couples Counseling Pllc | Counselor | 5085 Morganton Road, Suite 300, Fayetteville, NC 28314 | 2020-02-28 |
| 1346898335 | Chaitanya Joopally Dds Pllc | Dentist | 2050 Skibo Rd. Ste 104, Fayetteville, NC 28314 | 2019-09-03 |
| 1780231894 | Bio-medical Applications of North Carolina, Inc. | Clinic/Center | 2360 Williamwood Lane, Fayetteville, NC 28314 | 2019-08-22 |
| 1164075982 | A Touch of Grace Inc | Day Training/Habilitation Specialist | 2153 Heathcote Drive, Fayetteville, NC 28314 | 2019-07-21 |
| 1093284465 | Candice Gorremans | Physician Assistant | 108th Air Defense Artillery Brigade, Fort Bragg, NC 28314 | 2018-11-15 |
| 1861983439 | Jessica Lynne Smith | Counselor | 6885 Cliffdale Rd Ste 2002, Fayetteville, NC 28314 | 2018-05-19 |
| 1073003752 | Gooden Mobile Pod Nc Pllc | Podiatrist | 311 Mcfadyen Dr, Fayetteville, NC 28314 | 2018-05-17 |
| 1093222101 | Lauren Bonneau | Behavioral Analyst | 6985 Nexus Ct, Suite 107, Fayetteville, NC 28314 | 2018-01-10 |
| 1760900153 | Elali Alisha Marie Moukwa | Dentist | 1916 Skibo Rd Ste C3, Fayetteville, NC 28314 | 2017-09-06 |
| Find all providers in zip 28314 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245860618 | Robert Maughan | Physician Assistant | 129 Bryce Creek Ln, Fayetteville, NC 28303-4981 | 2020-01-24 |
| 1578050480 | Marlee Anne Fallon | Physician Assistant | 4402 Medical Center Dr Ste 402, Fayetteville, NY 13066-6626 | 2018-04-16 |
| 1285149781 | Rebecca Anderson | Physician Assistant | 413 Owen Dr Ste 201, Fayetteville, NC 28304-3490 | 2017-12-06 |
| 1750807186 | Julia Niemi | Physician Assistant | 2409 Murchison Rd # B, Fayetteville, NC 28301-3519 | 2017-08-17 |
| 1548709991 | Pallavi Annamaneni | Physician Assistant | 2149 Valleygate Dr Ste 102, Fayetteville, NC 28304-3666 | 2017-02-17 |
| 1124457650 | Amanda Warden | Physician Assistant | 89 Cowley Hollow Rd, Fayetteville, TN 37334-6947 | 2013-11-05 |
| 1639473739 | Andrea Bethauser | Physician Assistant | 918 Hope Mills Rd, Fayetteville, NC 28304-4243 | 2011-01-04 |
| 1891928941 | Gladys Maria Rivero | Physician Assistant | 3450 Sandystone Cir, Fayetteville, NC 28311-2503 | 2009-08-24 |
| 1366524092 | Lisa Aldrin Rojeski | Physician Assistant | 4038 N Remington Dr, Suite 4, Fayetteville, AR 72703-6345 | 2006-10-20 |
| 1902829039 | Michael John Winn | Physician Assistant | 5511 Raeford Road, Suite 150, Fayetteville, NC 28304-2058 | 2006-07-26 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 28314 |
Please comment or provide details below to improve the information on MS. KENYA DEMETA 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.