Charles Marcus Bass Jr., PA
Physician Assistant in Gainesville, GA. Individual provider (NPI-1).
NPI number1306100979
StatusActive
Last updated in NPPESSep 20, 2018
Details
- NPI
- 1306100979
- Entity type
- Individual (NPI-1)
- Name
- Mr. Charles Marcus Bass Jr.
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 28, 2012
- Last updated
- Sep 20, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 006476 | GA | Yes |
Practice location
1485 Jesse Jewell Pkwy Ne Ste 220aGainesville, GA 30501
Phone 770-740-1860 · Fax 678-347-2104
Mailing address
925 N Point Pkwy Ste 130Alpharetta, GA 30005-5211
Phone 770-740-1860 · Fax 678-347-2104
Other practice locations
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 116 Physician Assistant providers in Gainesville · All 3,664 providers in Gainesville
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