Active NPI
Richard Thomas Bauman, DMD
- Endodontics
- Murray, UT
National Provider Identifier
1639274145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 5930166
- Practice address
- 6065 S Fashion Blvd
#275
Murray, UT 84107-7381 - Phone
- (801) 590-8687
- Fax
- (801) 590-8617
- NPI assigned
- Sep 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 5930166 | UT | Primary |
Addresses
Primary practice location
6065 S Fashion Blvd
#275
Murray, UT 84107-7381
Mailing address
6065 S Fashion Blvd
#275
Murray, UT 84107-7381
Phone (801) 590-8687
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130719000766 | UT | Order and Referring Only - Oral Surgery | 1355582164 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5930166 | UT | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346803200000",
"number": "1639274145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6065 S FASHION BLVD",
"address_2": "#275",
"city": "MURRAY",
"state": "UT",
"postal_code": "841077381",
"telephone_number": "801-590-8687",
"fax_number": "801-590-8617"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6065 S FASHION BLVD",
"address_2": "#275",
"city": "MURRAY",
"state": "UT",
"postal_code": "841077381",
"telephone_number": "801-590-8687",
"fax_number": "801-590-8617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUMAN",
"first_name": "RICHARD",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2012-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "UT",
"license": "5930166",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2012; 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.