Active NPI
Mary Margaret Bachman-Moran, MA,LLP
- Psychologist
- Gaylord, MI
National Provider Identifier
1366645095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301003298
- Practice address
- 800 Livingston Blvd Ste B
Gaylord, MI 49735-8351 - Phone
- (989) 732-6292
- Fax
- (989) 732-0780
- NPI assigned
- Jun 8, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301003298 | MI | Primary |
Addresses
Primary practice location
800 Livingston Blvd Ste B
Gaylord, MI 49735-8351
Mailing address
2131 S M 66
East Jordan, MI 49727-9169
Phone (231) 631-8856
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301003298 | MI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366645095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2131 S M 66",
"city": "EAST JORDAN",
"state": "MI",
"postal_code": "497279169",
"telephone_number": "231-631-8856"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 LIVINGSTON BLVD STE B",
"city": "GAYLORD",
"state": "MI",
"postal_code": "497358351",
"telephone_number": "989-732-6292",
"fax_number": "989-732-0780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BACHMAN-MORAN",
"first_name": "MARY",
"middle_name": "MARGARET",
"credential": "MA,LLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301003298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gaylord, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.