Individual provider Active NPI

Jo Anne Bakeman, RN, CASAC

  • Addiction (Substance Use Disorder) Counselor
  • Fulton, NY
National Provider Identifier
1346583804
Registry record updated Apr 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
4364 Issued in NY
Practice address
163 S 1St St
Fulton, NY 13069-1721
Phone
(315) 427-3899
Fax
(315) 458-2538
NPI assigned
Apr 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 4364 NY Primary
Registered Nurse 163W00000X 252125-1 NY

Addresses

Primary practice location

163 S 1St St
Fulton, NY 13069-1721

Mailing address

202 E Patricia LN
North Syracuse, NY 13212-3218
Phone (315) 458-2538

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4364NYMDAddiction (Substance Use Disorder) Counselor
252125-1NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1346583804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E PATRICIA LN",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132123218",
            "telephone_number": "315-458-2538",
            "fax_number": "315-458-2538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 S 1ST ST",
            "city": "FULTON",
            "state": "NY",
            "postal_code": "130691721",
            "telephone_number": "315-427-3899",
            "fax_number": "315-458-2538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKEMAN",
        "first_name": "JO ANNE",
        "name_prefix": "Ms.",
        "credential": "RN, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "4364",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "252125-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; 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.