Jennifer Eve Bachman, PT
Individual provider Active NPI Specialist · Bahama, NC
NPI 1104028075 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104028075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 4863 (NC)
- Practice address
- 8501 Doughton Dr
Bahama, NC 27503-8992 - Phone
- (919) 620-6666
- NPI assigned
- Jun 4, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240318000180 | NC | Practitioner - Physical Therapist in Private Practice | 4082050778 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4863 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Duke University Health System, Inc. | Physical Therapist | Current |
Accepting new patients |
| Duke University Health System, Inc. | Current |
Accepting new patients | |
| Duke University Health System, Inc. | Past | Accepting new patients |
Locations
1821 Hillandale Rd
Ste 25B
Durham, NC 27705
Phone (919) 613-9105
2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 4863 | NC | Yes |
Addresses
Primary practice location
8501 Doughton Dr
Bahama, NC 27503-8992
Mailing address
8501 Doughton Dr
Bahama, NC 27503-8992
Phone (919) 620-6666
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4863 | Other | NC | PHYSICAL THERAPY |
Other providers in Bahama, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.