Individual provider Active NPI

Brian J Bauer, MSN

  • Pediatric Nurse Practitioner
  • Norman, OK
National Provider Identifier
1083974836
Registry record updated Jan 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
93020 Issued in OK
Practice address
500 E Robinson St
Suite 2600
Norman, OK 73071-6697
Phone
(405) 364-6432
Fax
(405) 928-7513
NPI assigned
May 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 93020 OK Primary

Addresses

Primary practice location

500 E Robinson St
Suite 2600
Norman, OK 73071-6697

Mailing address

500 E Robinson St
Suite 2600
Norman, OK 73071-6697
Phone (405) 364-6432

Other identifiers 1

IdentifierTypeStateIssuer
200436340AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240716001356 OK Practitioner - Nurse Practitioner 5698210581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shortgrass Community Health Center Inc 7 clinicians

Practice addresses (Care Compare)

400 E Sycamore St
Hollis, OK 73550-1436
Phone (580) 688-2800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
93020OKMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shortgrass Community Health Center, Inc CurrentSince May 3, 2024 Accepting new patients
Shortgrass Community Health Center, Inc CurrentSince May 3, 2024 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

101 S Hudson St
Altus, OK 73521
Phone (580) 301-6154

400 E Sycamore St
Hollis, OK 73550
Phone (580) 688-2800

Interoperability endpoints

  • Direct secure messaging: brianbauer@schc.secure.relimedsolutions.com

Organizations & group practices 4

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": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389225600000",
    "number": "1083974836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E ROBINSON ST",
            "address_2": "SUITE 2600",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716697",
            "telephone_number": "405-364-6432",
            "fax_number": "405-928-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E ROBINSON ST",
            "address_2": "SUITE 2600",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716697",
            "telephone_number": "405-364-6432",
            "fax_number": "405-928-7513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "BRIAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MSN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-25",
        "last_updated": "2014-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OK",
            "license": "93020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200436340A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.