Individual provider Active NPI

Kathryn Elizabeth Baumgartner, DO

  • Family Medicine Physician
  • Okemos, MI
National Provider Identifier
1194349969
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101026877 Issued in MI
Practice address
2446 Jolly Rd Ste B
Okemos, MI 48864-3514
Phone
(517) 253-5530
Fax
(517) 253-5535
NPI assigned
Jun 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101026877 MI Primary

Addresses

Primary practice location

2446 Jolly Rd Ste B
Okemos, MI 48864-3514

Mailing address

2446 Jolly Rd Ste B
Okemos, MI 48864-3514
Phone (517) 253-5530

Other practice location 1

1215 E Michigan Ave
Lansing, MI 48912-1896
Phone (517) 364-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230613003193 MI Practitioner - Family Practice 2365865318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Edward W Sparrow Hospital AssociationGroup PAC ID 6709799166, 698 clinicians

Practice addresses (Care Compare)

230 Temple St
Mason, MI 48854-1851
Phone (517) 676-9066

2446 Jolly Rd
Suite B
Okemos, MI 48864-3514
Phone (517) 253-5530

Hospital & facility affiliations

  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101026877MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Edward W Sparrow Hospital Association Family Medicine CurrentSince Aug 1, 2023 Accepting new patients
Edward W. Sparrow Hospital Association Family Medicine Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients

Locations

8175 Reliable Pkwy
Chicago, IL 60686

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

230 Temple St
Mason, MI 48854
Phone (517) 676-4545

2446 Jolly Rd
Ste B
Okemos, MI 48864
Phone (517) 253-5530

Organizations & group practices 4

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

Hospital & facility affiliations 2

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": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1194349969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2446 JOLLY RD STE B",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643514",
            "telephone_number": "517-253-5530",
            "fax_number": "517-253-5535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2446 JOLLY RD STE B",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643514",
            "telephone_number": "517-253-5530",
            "fax_number": "517-253-5535"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Lansing",
            "state": "MI",
            "postal_code": "489121896",
            "country_code": "US",
            "telephone_number": "517-364-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUMGARTNER",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101026877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.