Nicole Baughn
Individual provider Active NPI Family Nurse Practitioner · Watertown, NY
NPI 1285213397 · NPPES record last updated Feb 24, 2025
Key facts
- NPI
- 1285213397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 347551 (NY)
- Practice address
- 160 Stone St
Watertown, NY 13601-3250 - Phone
- (315) 788-8065
- NPI assigned
- Apr 6, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Planned Parenthood of the North Country New York, Inc.
Practice addresses (Care Compare)
160 Stone St
Watertown, NY 13601-3250
Phone (315) 788-8065
Hospital & facility affiliations
- The University of Vermont Health Network - Champl
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210430000023 | NY | Practitioner - Nurse Practitioner | 7517376791 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 347551 | NY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Planned Parenthood of the North Country New York, Inc. | Current |
Accepting new patients | |
| Planned Parenthood of Central and Western New York, Inc | Past | Accepting new patients | |
| Northern Adirondack Planned Parenthood Inc | Past | Accepting new patients |
Locations
9 Miner St
Canton, NY 13617
Phone (315) 386-8821
7398 Turin Rd
Lowville, NY 13367
Phone (315) 804-6174
419 Ford St
Ogdensburg, NY 13669
Phone (315) 393-0392
66 Brinkerhoff St
Plattsburgh, NY 12901
Phone (518) 561-0605
114 University Ave
Rochester, NY 14605
Phone (585) 546-2771
41 Saint Bernard St
Saranac Lake, NY 12983
Phone (518) 354-8335
160 Stone St
Watertown, NY 13601
Phone (315) 782-1818
Interoperability endpoints
- nicole.zetterberg.p2@direct.usppny.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 347551 | NY | Yes |
Addresses
Primary practice location
160 Stone St
Watertown, NY 13601-3250
Mailing address
114 University Ave
Rochester, NY 14605-2992
Phone (585) 371-8373
Other names
- Nicole Zetterberg
Other providers in Watertown, NY
- Jennifer Rose Barse
- Paul D Barter
- Michelle Ann Bartlett
- Yvonne Victoria Bates
- Alivia Battisti
- Steven Edwin Beach Jr.
- Samantha Ann Bearup
- Ann Compo Bedard
- Ava E Beebe
- Bradd J Beimford
All providers in Watertown, NY · Family Nurse Practitioner in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 24, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.