Individual provider Active NPI

Marie Anne Bakitas, DNSC, APRN

  • Adult Health Nurse Practitioner
  • Lebanon, NH
National Provider Identifier
1396789699
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
026561-23 Issued in NH
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 650-5402
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 026561-23 NH Primary
Adult Health Nurse Practitioner 363LA2200X 101-0026301 VT

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
Palliative Medicine
Lebanon, NH 03756-1000
Phone (603) 650-5402

Other identifiers 2

IdentifierTypeStateIssuer
0NP2705MedicaidVT
30341008MedicaidNH

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
026561-23NHMDAdult Health Nurse Practitioner
101-0026301VTMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1396789699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "PALLIATIVE MEDICINE",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-5402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKITAS",
        "first_name": "MARIE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DNSC, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NH",
            "license": "026561-23",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VT",
            "license": "101-0026301",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0NP2705",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30341008",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.