Active NPI
Kerry Beth Baumann, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1336557628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9736
- Practice address
- Nmcsd Laboratory Eda 13 Suite 305
34800 Bob Wilson Drive
San Diego, CA 92134 - Phone
- (518) 598-4190
- NPI assigned
- Jul 30, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9736 | NC | Primary |
Addresses
Primary practice location
Nmcsd Laboratory Eda 13 Suite 305
34800 Bob Wilson Drive
San Diego, CA 92134
Mailing address
Nmcsd Laboratory Eda 13 Suite 305
34800 Bob Wilson Drive
San Diego, CA 92134
Phone (518) 598-4190
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kerry.b.baumann.mil@mail.mil |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9736 | NC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681430400000",
"number": "1336557628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NMCSD LABORATORY EDA 13 SUITE 305",
"address_2": "34800 BOB WILSON DRIVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92134",
"telephone_number": "518-598-4190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NMCSD LABORATORY EDA 13 SUITE 305",
"address_2": "34800 BOB WILSON DRIVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92134",
"telephone_number": "518-598-4190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUMANN",
"first_name": "KERRY",
"middle_name": "BETH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-30",
"last_updated": "2023-04-14",
"certification_date": "2023-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "9736",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kerry.b.baumann.mil@mail.mil",
"affiliation": "N",
"address_1": "620 John Paul Jones Cir",
"city": "Portsmouth",
"state": "VA",
"country_code": "US",
"postal_code": "237082111",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.