Active NPI
Susan F Bauman, RN NP
- Nurse Practitioner
- Mankato, MN
National Provider Identifier
1114906120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R0743451
- Practice address
- 1230 E Main St
Mankato Clinic at Main Street
Mankato, MN 56001-5066 - Phone
- (507) 625-1811
- Fax
- (507) 625-1878
- NPI assigned
- Jan 10, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R0743451 | MN | Primary |
Addresses
Primary practice location
1230 E Main St
Mankato Clinic at Main Street
Mankato, MN 56001-5066
Mailing address
1230 E Main St
PO Box 8674
Mankato, MN 56001-5066
Phone (507) 625-1811
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 599214100 | Medicaid | MN | |
| NA2951023871 | Other | MN | PREFERRED ONE |
| 03A64BA | Other | MN | BCBS |
| 500004161 | Other | RR MEDICARE | |
| 41084933956001C158 | Other | CHAMPUS | |
| 938480 | Medicaid | IA | |
| 0401492 | Other | MN | MEDICA |
| 124709 | Other | MN | UCARE |
| HP40993 | Other | MN | HEALTH PARTNERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1114906120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1230 E MAIN ST",
"address_2": "PO BOX 8674",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015066",
"telephone_number": "507-625-1811",
"fax_number": "507-625-1878"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 E MAIN ST",
"address_2": "MANKATO CLINIC AT MAIN STREET",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015066",
"telephone_number": "507-625-1811",
"fax_number": "507-625-1878"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUMAN",
"first_name": "SUSAN",
"middle_name": "F",
"credential": "RN NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-10",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "R0743451",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "599214100",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "NA2951023871",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "03A64BA",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "500004161",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "41084933956001C158",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "938480",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "0401492",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "124709",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PARTNERS",
"identifier": "HP40993",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.