Individual provider Active NPI

Paul Baysinger, LPC

  • Professional Counselor
  • Eagle River, AK
National Provider Identifier
1649649997
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
102720 Issued in AK
Practice address
11723 Old Glenn Hwy Ste 203
Eagle River, AK 99577-7750
Phone
(907) 406-7640
Fax
(877) 354-5075
NPI assigned
Sep 16, 2015
Last updated
Dec 19, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 102720 AK Primary

Addresses

Primary practice location

11723 Old Glenn Hwy Ste 203
Eagle River, AK 99577-7750

Mailing address

11723 Old Glenn Hwy Ste 203
Eagle River, AK 99577-7750
Phone (907) 406-7640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
102720AKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Recovery Waters Counseling LLC CurrentSince Dec 10, 2023 Accepting new patients
Recovery Waters Physical Therapy LLC CurrentSince Jul 15, 2019 Accepting new patients

Locations

9061 E Frontage Rd
Palmer, AK 99645
Phone (907) 331-6992

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": "1442361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1649649997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11723 OLD GLENN HWY STE 203",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777750",
            "telephone_number": "907-406-7640",
            "fax_number": "877-354-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11723 OLD GLENN HWY STE 203",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777750",
            "telephone_number": "907-406-7640",
            "fax_number": "877-354-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAYSINGER",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-16",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "102720",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle River, AK

Sources for this page

Verify at the official NPI Registry.