Individual provider Active NPI

Lynda J. Bahde, APNP

  • Family Nurse Practitioner
  • Marinette, WI
National Provider Identifier
1104897412
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1704-033 Issued in WI
Practice address
2935 Shore Dr
Marinette, WI 54143-4237
Phone
(715) 732-9193
Fax
(715) 732-9196
NPI assigned
Jan 27, 2006
Last updated
May 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1704-033 WI Primary
Family Nurse Practitioner 363LF0000X 4704200437 MI

Addresses

Primary practice location

2935 Shore Dr
Marinette, WI 54143-4237

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7226

Other identifiers 1

IdentifierTypeStateIssuer
43914800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051129000229 WI Practitioner - Nurse Practitioner 8729008362 Reassigns benefits to 2 organizations
I20071026000723 MI Practitioner - Nurse Practitioner 8729008362 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, shared by 12 NPIs, 217 clinicians
Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Practice addresses (Care Compare)

106 S School Rd
Daggett, MI 49821-8555
Phone (906) 753-2155

2820 Roosevelt Rd
Marinette, WI 54143-3834
Phone (715) 735-5225

3200 Shore Dr
Marinette, WI 54143-4202
Phone (715) 732-1392

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1704WIMDClinical Psychologist
4704200437MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc CurrentSince Nov 14, 2016 Accepting new patients
Oconto Hospital & Medical Center, Inc. CurrentSince Apr 7, 2018 Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Nov 14, 2016 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Nov 14, 2016 Accepting new patients
Oconto Hospital & Medical Center Inc Current Accepting new patients
Oconto Hospital & Medical Center, Inc. Current Accepting new patients
Oconto Hospital & Medical Center Inc CurrentSince Nov 14, 2016 Accepting new patients
Bellin Memorial Hospital Inc Current Accepting new patients
Northreach Healthcare, LLC Past Accepting new patients

Locations

106 S School Rd
Daggett, MI 49821
Phone (906) 753-2155

1100 10th St
Menominee, MI 49858
Phone (906) 863-2256

218 S US Highway 141
Crivitz, WI 54114
Phone (715) 854-7477

1726 Shawano Ave
Green Bay, WI 54303
Phone (920) 432-6016

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171

3200 Shore Dr
Marinette, WI 54143
Phone (715) 732-8610

820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100

855 S Main St
Oconto Falls, WI 54154
Phone (920) 846-3444

Interoperability endpoints

  • Direct secure messaging: lbahde31928@direct.thedacare.org
  • Direct secure messaging: lbahde942886@direct.emplifyhealth.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1104897412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7226",
            "fax_number": "920-445-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 SHORE DR",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541434237",
            "telephone_number": "715-732-9193",
            "fax_number": "715-732-9196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHDE",
        "first_name": "LYNDA",
        "middle_name": "J.",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-27",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "1704-033",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704200437",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43914800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marinette, WI

Sources for this page

Verify at the official NPI Registry.