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MRS. KELLEY JOHANNA BASS PA-C
NPI 1316112295
Physician Assistant - Surgical in St. Louis, MO

Active since April 23, 2008
621 S. NEW BALLAS RD., SUITE 297-A, ST. LOUIS, MO 63141(314) 251-6364(314) 251-7897 Get Directions Write a Review

NPPES record last updated: June 12, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Kelley Johanna Bass Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. KELLEY JOHANNA BASS PA-C (NPI 1316112295) is an individual surgical provider in St. Louis, Missouri, licensed in Missouri (2008013830) and active in the NPI registry since April 2008.

NPPES Registry Identity

NPI1316112295
Entity TypeIndividualFemale
Primary Taxonomy363AS0400X
Provider Legal NameMRS. KELLEY JOHANNA BASSCredential: PA-C
Location Address621 S. NEW BALLAS RD., SUITE 297-ASt. Louis, MO 63141-8200
Mailing Address15317 Coventry Woods CtChesterfield, MO 63017-7500 · (636) 220-2309
Phone(314) 251-6364
Fax(314) 251-7897
Sole ProprietorNo
Enumeration DateApril 23, 2008
Last NPPES UpdateJune 12, 2008
✔ NPI 1316112295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in MO · 2008013830
621 S. NEW BALLAS RD., St. Louis, MO 63141
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. ANN LUTZEIER PEICK M.D.
Surgery (Trauma Surgery)
621 S. NEW BALLAS RD., SUITE 560A
ST LOUIS, MO 63141
St. Louis County (314) 251-6440
DR. JOSHUA DAVID BINEK M.D.
Internal Medicine
621 S. NEW BALLAS RD., SUITE 507A
SAINT LOUIS, MO 63141
St. Louis County (314) 251-5746
M. EDWARD MIMLITZ PC
Obstetrics & Gynecology
621 S. NEW BALLAS RD., SUITE 419-A
ST. LOUIS, MO 63141
St. Louis County (314) 432-8505

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelley Bass's NPI number?

The NPI number for Kelley Bass is 1316112295. It was assigned to this individual provider in the NPPES registry on April 23, 2008.

Where is Kelley Bass located?

Kelley Bass practices at 621 S. New Ballas Rd. Suite 297-A, St. Louis, MO 63141. The listed phone number is (314) 251-6364.

What is Kelley Bass's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Kelley Bass was last updated on June 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.