Individual provider Active NPI

Stephen R Bauer, D.O.

  • Pediatrics Physician
  • Columbus, OH
National Provider Identifier
1477648491
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34-00-3023 Issued in OH
Practice address
111 Inah Ave
Columbus, OH 43228-1705
Phone
(614) 878-6415
Fax
(614) 878-7946
NPI assigned
Oct 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34-00-3023 OH Primary

Addresses

Primary practice location

111 Inah Ave
Columbus, OH 43228-1705

Mailing address

111 Inah Ave
Columbus, OH 43228-1705
Phone (614) 878-6415

Other identifiers 1

IdentifierTypeStateIssuer
0489832MedicaidOH

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
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Academic Association, Inc. Pediatrics Past Accepting new patients
Child Care Consultants Pediatrics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477648491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 INAH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281705",
            "telephone_number": "614-878-6415",
            "fax_number": "614-878-7946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 INAH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281705",
            "telephone_number": "614-878-6415",
            "fax_number": "614-878-7946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "STEPHEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34-00-3023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0489832",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

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.

Verify at the official NPI Registry.