Individual provider Active NPI

Tina L Bauler, RNFA

  • Registered Nurse First Assistant
  • Mesa, AZ
National Provider Identifier
1124081500
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
RN079847 Issued in AZ
Practice address
8724 E Rose St
Mesa, AZ 85208-1528
Phone
(480) 545-2610
Fax
(480) 545-2373
NPI assigned
Apr 7, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN079847 AZ Primary

Addresses

Primary practice location

8724 E Rose St
Mesa, AZ 85208-1528

Mailing address

PO Box 52320
Mesa, AZ 85208-0116
Phone (480) 545-2610

Other identifiers 3

IdentifierTypeStateIssuer
844771MedicaidAZ
AZ0280450OtherAZBCBS
1Z5768OtherAZHEALTHNET OF AZ

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN079847AZMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1124081500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52320",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852080116",
            "telephone_number": "480-545-2610",
            "fax_number": "480-545-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8724 E ROSE ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852081528",
            "telephone_number": "480-545-2610",
            "fax_number": "480-545-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAULER",
        "first_name": "TINA",
        "middle_name": "L",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "AZ",
            "license": "RN079847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "844771",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0280450",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET OF AZ",
            "identifier": "1Z5768",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.