Individual provider Active NPI

Anne Elizabeth Baerwald, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Wilkes Barre, PA
National Provider Identifier
1265958334
Registry record updated Aug 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
402275 Issued in NY
Practice address
1111 E End Blvd
Wilkes Barre, PA 18711-0030
Phone
(570) 824-3521
NPI assigned
Aug 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 402275 NY Primary

Addresses

Primary practice location

1111 E End Blvd
Wilkes Barre, PA 18711-0030

Mailing address

50 Church St
Kingston, PA 18704-4959

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
402275NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1503187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503187200000",
    "number": "1265958334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 CHURCH ST",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187044959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E END BLVD",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110030",
            "telephone_number": "570-824-3521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAERWALD",
        "first_name": "ANNE",
        "middle_name": "ELIZABETH",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-20",
        "last_updated": "2017-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "402275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilkes Barre, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2017; 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.