Individual provider Active NPI

McKenzie Ann Bauman

  • Physician Assistant
  • Concord, NC
National Provider Identifier
1548884380
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-11311 Issued in NC
Practice address
1070 Vinehaven Dr NE
Concord, NC 28025-2438
Phone
(704) 783-1840
NPI assigned
Jun 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X
Physician Assistant 363A00000X 0010-11311 NC Primary

Addresses

Primary practice location

1070 Vinehaven Dr NE
Concord, NC 28025-2438

Mailing address

1070 Vinehaven Dr NE
Concord, NC 28025-2438
Phone (704) 783-1840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211020000141 NC Practitioner - Physician Assistant 3678961943 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

105 Yadkin St
Suite 203
Albemarle, NC 28001-3459
Phone (980) 323-5300

1070 Vinehaven Dr NE
Concord, NC 28025-2438
Phone (704) 783-1840

510 Corporate Cir
Suite 1000
Salisbury, NC 28147-8074
Phone (704) 783-1840

9965 Poplar Tent Rd
Concord, NC 28027-9304
Phone (704) 783-1833

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cabarrus Gastroenterology Associates, PLLC CurrentSince Aug 1, 2021 Accepting new patients
Cabarrus Gastroenterology Associates, PLLC Past Accepting new patients
Cabarrus Gastroenterology Associates, PLLC Past Accepting new patients

Locations

9965 Poplar Tent Rd
Concord, NC 28027
Phone (704) 783-1840

1070 Vinehaven Dr NE
Concord, NC 28025
Phone (704) 783-1840

510 Corporate Cir
#1000
Salisbury, NC 28147
Phone (704) 783-1840

Interoperability endpoints

  • Direct secure messaging: mbauman815567@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 4

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1591401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1548884380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 VINEHAVEN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252438",
            "telephone_number": "704-783-1840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 VINEHAVEN DR NE",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280252438",
            "telephone_number": "704-783-1840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMAN",
        "first_name": "MCKENZIE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-06",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.