Marianne Bae

Primary specialty

Dental AssistantTaxonomy code 126800000X

Practice address

BLDG 2441 21St Street
US Army Dental Activity
Fort Campbell, KY 42223

Phone

(270) 798-8977

Fax

(270) 956-0266

NPI assigned

Jun 13, 2016

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 13, 2016.

{
    "created_epoch": "1465776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465776000000",
    "number": "1457700247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDG 2441 21ST STREET",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-8977",
            "fax_number": "270-956-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 2441 21ST STREET",
            "address_2": "US ARMY DENTAL ACTIVITY",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-8977",
            "fax_number": "270-956-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAE",
        "first_name": "MARIANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-13",
        "last_updated": "2016-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carson Ayers, CRNA
• Stephen J Baciak II, DPT
• Jamie L Back, REGISTERED
• Ferdinand K. Bacomo, DO
• Laura Lesa Bacon, R.N.
• Jennifer R Baggett, MS
• Kimberly Bailey
• Shawn M Bailey, PT, DPT, OCS
• Gena Baisa, RDN
• Michael Robert Baker, D.P.M.

• All providers in Fort Campbell, KY
• Dental Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.