Individual provider Active NPI

Jacquelyn P Bauer, C.R.N.P.

  • Pediatric Nurse Practitioner
  • Oakland, MD
National Provider Identifier
1124010004
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
R110105 Issued in MD
Practice address
1027 Memorial Dr
Oakland, MD 21550-4343
Phone
(301) 533-3300
Fax
(833) 448-0361
NPI assigned
Aug 17, 2005
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X R110105 MD
Pediatric Nurse Practitioner 363LP0200X R110105 MD Primary
Pediatric Nurse Practitioner 363LP0200X SP018623 PA

Addresses

Primary practice location

1027 Memorial Dr
Oakland, MD 21550-4343

Mailing address

1027 Memorial Dr
Oakland, MD 21550-4343
Phone (301) 533-3300

Other practice location 1

12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone (240) 964-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV, MD, VA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20050315000327 WV Practitioner - Nurse Practitioner 7719932524 Reassigns benefits to 1 organization
I20130311000045 MD Practitioner - Nurse Practitioner 7719932524 Reassigns benefits to 4 organizations
I20140507000793 VA Practitioner - Nurse Practitioner 7719932524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Maryland Health Care CorporationGroup PAC ID 9436152493, shared by 6 NPIs, 29 clinicians

Practice addresses (Care Compare)

1027 Memorial Dr
Oakland, MD 21550-4343
Phone 30153333003081

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R110105MDMDNeonatal Nurse Practitioner
SP018623PAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince Mar 1, 2014 Accepting new patients
Western Maryland Health Care Corporation CurrentSince Dec 15, 2025 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Aug 1, 2022 Accepting new patients
Western Maryland Health Care Corporation CurrentSince Dec 15, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Mar 5, 2018 Accepting new patients
West Virginia University Medical Corporation CurrentSince Mar 5, 2018 Accepting new patients
Children's Medical Group, P.a. CurrentSince Mar 1, 2013 Accepting new patients
Winchester Medical Center Current Accepting new patients
Winchester Medical Center CurrentSince Mar 1, 2014 Accepting new patients
University of Maryland St. Joseph Medical Group, LLC CurrentSince Aug 1, 2022 Accepting new patients
Wellcare Inc CurrentSince May 26, 2025 Accepting new patients
Conemaugh Health Initiatives Past Accepting new patients
Western Maryland Health Care Corporation Past Accepting new patients
Western Maryland Health Care Corporation Past Accepting new patients
Upmc Western Maryland Corporation Past Accepting new patients
Western Maryland Health Care Corporation Past Accepting new patients

Locations

500 Greene St
Cumberland, MD 21502
Phone (301) 724-7616

1 Science Park
Frostburg, MD 21532
Phone (301) 729-2235

104 Parkview Dr
Grantsville, MD 21536
Phone (301) 895-5107

1226 National Hwy
Lavale, MD 21502
Phone (301) 709-0357

1027 Memorial Dr
Oakland, MD 21550
Phone (301) 533-3300

7601 Osler Dr
Towson, MD 21204
Phone (410) 337-1150

22221 Westernport Rd SW
Westernport, MD 21562
Phone (240) 774-0204

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Interoperability endpoints

  • Direct secure messaging: jacquelyn.bauer.1@28818.direct.athenahealth.com
  • Direct secure messaging: jacquelynbauercrnp@childrensm.allscriptsdirect.net
  • Direct secure messaging: jbauer1051703@direct.hopkinsmedicine.org

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1124010004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 MEMORIAL DR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215504343",
            "telephone_number": "301-533-3300",
            "fax_number": "833-448-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 MEMORIAL DR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215504343",
            "telephone_number": "301-533-3300",
            "fax_number": "833-448-0361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12500 Willowbrook Rd",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "MD",
            "postal_code": "215026393",
            "country_code": "US",
            "telephone_number": "240-964-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUER",
        "first_name": "JACQUELYN",
        "middle_name": "P",
        "credential": "C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MD",
            "license": "R110105",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MD",
            "license": "R110105",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP018623",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

Verify at the official NPI Registry.