Individual provider Active NPI

Michele Patterson-Bauman, APRN

  • Gerontology Nurse Practitioner
  • Ormond Beach, FL
National Provider Identifier
1194565879
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11033047 Issued in FL
Practice address
325 Clyde Morris Blvd Ste 340
Ormond Beach, FL 32174-3199
Phone
(609) 816-6439
NPI assigned
May 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN11033047 FL Primary

Addresses

Primary practice location

325 Clyde Morris Blvd Ste 340
Ormond Beach, FL 32174-3199

Mailing address

325 Clyde Morris Blvd Ste 340
Ormond Beach, FL 32174-3199
Phone (386) 615-8971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240808001251 FL Practitioner - Nurse Practitioner 5698212686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kashyap Patel MD PAGroup PAC ID 9830152974, 7 clinicians

Practice addresses (Care Compare)

325 Clyde Morris Blvd
Suite 340
Ormond Beach, FL 32174-3199
Phone (386) 615-8971

Hospital & facility affiliations

  • Halifax Health Medical Center Hospital, Daytona Beach, FL, CCN 100017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN11033047FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kashyap Patel MD PA CurrentSince Jul 8, 2024 Accepting new patients
Volusia & Flagler OB-GYN PA Past Accepting new patients

Locations

312 W New York Ave
Deland, FL 32720
Phone (386) 775-2921

598 Sterthaus Dr
#C
Ormond Beach, FL 32174
Phone (386) 672-9683

325 Clyde Morris Blvd
Ste 340
Ormond Beach, FL 32174
Phone (386) 212-3273

322 Big Tree Rd
South Daytona, FL 32119
Phone (386) 310-8745

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 2

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 1

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": "1716940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1194565879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 CLYDE MORRIS BLVD STE 340",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743199",
            "telephone_number": "386-615-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 CLYDE MORRIS BLVD STE 340",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743199",
            "telephone_number": "609-816-6439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON-BAUMAN",
        "first_name": "MICHELE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-29",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11033047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

Verify at the official NPI Registry.