Marc A Bauder, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

15235 Issued in AZ

Practice address

1000 Willow Creek Rd
Suite G
Prescott, AZ 86301-1645

Phone

(928) 458-7343

Fax

(928) 257-4422

NPI assigned

Apr 10, 2006

Last updated

Mar 13, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avalon Biotechnical Corporation

  • Geriatric Medicine (Family Medicine) Physician
  • Lakeside, AZ
  • NPI 1942326020
  NPD (past) Authorized official
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Teec Nos Pos, AZ
  • NPI 1477615789
  NPD (past)
• Lakeside Chiropractic PC

  • Clinic/Center
  • Show Low, AZ
  • NPI 1417133265
  NPD (past)
• Nca Holdings of Arizona, LLC

  dba New Promise Neuropathy Care Centers

  • Internal Medicine Physician
  • Peoria, AZ
  • NPI 1184973018
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394668800000",
    "number": "1457314601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 WILLOW CREEK RD",
            "address_2": "SUITE G",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011645",
            "telephone_number": "928-458-7343",
            "fax_number": "928-257-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WILLOW CREEK RD",
            "address_2": "SUITE G",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011645",
            "telephone_number": "928-458-7343",
            "fax_number": "928-257-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUDER",
        "first_name": "MARC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2014-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "15235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "249872",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane Barrera, NP
• Robert T Barry, MD
• Richard Keith Bassett, DO
• Thomas A. Bast, FNP
• Bethany Bates, PSY.D.
• Rodney W Bauer, OD
• Eric Baumann, MD
• McKenna L Baxter, SLPA
• Stephen Baxter, LMT
• Bayada Home Health Care, Inc.

• Geriatric Medicine (Family Medicine) Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Geriatric Medicine (Family Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.