Kylee Maureen Bakker

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NUR-APRN-LIC-176062 Issued in MT

Practice address

1400 29TH St S
Great Falls, MT 59405-5315

Phone

(406) 771-3252

NPI assigned

Jul 13, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: krmcmedicalrecords@krhdirect.org
• FHIR API: https://api.platform.athenahealth.com/25095/brand/1/csg/1/fhir/r4

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.

• Great Falls Clinic LLC

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1801897780

  MT

  Medicare reassignment NPD
• Logan Health - Conrad

  • Critical Access Hospital
  • Conrad, MT
  • NPI 1467445049

  MT

  Medicare reassignment NPD
• Northern Rockies Medical Center, Inc.

  • Critical Access Hospital
  • Cut Bank, MT
  • NPI 1831143080

  MT

  Medicare reassignment NPD
• Logan Health - Conrad

  • Rural Health Clinic/Center
  • Conrad, MT
  • NPI 1669461703
  NPD
• Logan Health - Conrad

  • Ambulance
  • Conrad, MT
  • NPI 1790803765
  NPD
• Northern Rockies Medical Center, Inc.

  • Rural Health Clinic/Center
  • Cut Bank, MT
  • NPI 1568416717
  NPD

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1619453552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 N WISCONSIN ST",
            "city": "CONRAD",
            "state": "MT",
            "postal_code": "594251829",
            "telephone_number": "406-781-3998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 29TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594055315",
            "telephone_number": "406-771-3252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Sand Point Way NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053901",
            "country_code": "US",
            "telephone_number": "206-987-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "802 2nd St SE",
            "address_purpose": "LOCATION",
            "city": "Cut Bank",
            "state": "MT",
            "postal_code": "594273329",
            "country_code": "US",
            "telephone_number": "406-873-2251",
            "fax_number": "406-873-3118",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "805 Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "Conrad",
            "state": "MT",
            "postal_code": "594251717",
            "country_code": "US",
            "telephone_number": "406-271-3211",
            "fax_number": "406-271-3917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKKER",
        "first_name": "KYLEE",
        "middle_name": "MAUREEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-13",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MT",
            "license": "NUR-APRN-LIC-176062",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP60854096",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Logan Health - Conrad",
            "address_1": "805 Sunset Blvd",
            "city": "Conrad",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594251717",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krmcmedicalrecords@krhdirect.org",
            "affiliation": "Y",
            "affiliationName": "Northern Rockies Medical Center, Inc.",
            "address_1": "802 2nd St SE",
            "city": "Cut Bank",
            "state": "MT",
            "country_code": "US",
            "postal_code": "594273329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sandra L Bailey, D.O.
• Jaycee Harlee Baird
• Judith Anne Baird, LCSW
• Jeffrey Clinton Baker, MD
• Marwan Bakhach, M.D
• Balance Physical Therapy LLC
• Merhala Balasubramaniam, M.D.
• Ardine Balili, PA-C
• Anastasia Marie Balius, M.D.
• Jamal Abdul Yasser Balouch, DO

• All providers in Great Falls, MT
• Pediatric Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.