Individual provider Active NPI

Elizabeth L Bauer, FNP

  • Family Nurse Practitioner
  • Weiser, ID
National Provider Identifier
1255721361
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP-1552A Issued in ID
Practice address
683 E 3Rd St
Weiser, ID 83672-2248
Phone
(208) 549-0211
Fax
(208) 549-0104
NPI assigned
Jan 27, 2015
Last updated
Mar 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP-1552A ID Primary

Addresses

Primary practice location

683 E 3Rd St
Weiser, ID 83672-2248

Mailing address

683 E 3Rd St
Weiser, ID 83672-2248
Phone (208) 549-0211

Other names 1

  • Elizabeth Louise Lakey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20160428001529 ID Practitioner - Nurse Practitioner 6709185572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Two Rivers Medical Clinic, PAGroup PAC ID 8628065950, 3 clinicians

Practice addresses (Care Compare)

683 E 3Rd St
Weiser, ID 83672-2248
Phone (208) 549-0211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP-1552AIDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adams County Health Center Inc CurrentSince Nov 14, 2016 Accepting new patients
Two Rivers Medical Clinic, PA CurrentSince Mar 1, 2023 Accepting new patients

Locations

683 E 3rd St
Weiser, ID 83672
Phone (208) 549-0211

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1422316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1255721361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "683 E 3RD ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722248",
            "telephone_number": "208-549-0211",
            "fax_number": "208-549-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "683 E 3RD ST",
            "city": "WEISER",
            "state": "ID",
            "postal_code": "836722248",
            "telephone_number": "208-549-0211",
            "fax_number": "208-549-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "ELIZABETH",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-27",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "NP-1552A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "LAKEY",
            "middle_name": "LOUISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Weiser, ID

Sources for this page

Verify at the official NPI Registry.