Individual provider Active NPI

Jody L Bauer, ARNP

  • Family Nurse Practitioner
  • Bellingham, WA
National Provider Identifier
1003904061
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30004830 Issued in WA
Practice address
3111 Woburn St Ste 201
Bellingham, WA 98226-6610
Phone
(360) 734-1420
Fax
(360) 733-1659
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP30004830 WA Primary

Addresses

Primary practice location

3111 Woburn St Ste 201
Bellingham, WA 98226-6610

Mailing address

3111 Woburn St Ste 201
Bellingham, WA 98226-6610
Phone (360) 734-1420

Other identifiers 3

IdentifierTypeStateIssuer
RN00114758OtherWALICENSE
3022HOOtherWAREGENCE BLUE SHIELD
AP30004830OtherWALICENSE

Other names 1

  • Jody L Hoppis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100922000899 WA Practitioner - Nurse Practitioner 7012033491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30004830WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Gastroenterology Professional LLC CurrentSince Aug 1, 2015 Accepting new patients
Deichert Integrative Health LLC Family Past Accepting new patients

Locations

2979 Squalicum Pkwy
Ste 301
Bellingham, WA 98225
Phone (360) 734-1420

3111 Woburn St
Ste 201
Bellingham, WA 98226
Phone (360) 543-5054

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1003904061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3111 WOBURN ST STE 201",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266610",
            "telephone_number": "360-734-1420",
            "fax_number": "360-733-1659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 WOBURN ST STE 201",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266610",
            "telephone_number": "360-734-1420",
            "fax_number": "360-733-1659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "JODY",
        "middle_name": "L",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30004830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN00114758",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "3022HO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP30004830",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODY",
            "last_name": "HOPPIS",
            "middle_name": "L",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.