Mary Anne Baughman, PA-C
Individual provider Active NPI Physician Assistant · Cherokee, IA
NPI 1679601249 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1679601249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 1779 (IA)
- Practice address
- 1200 W Cedar Loop
Cherokee Mental Health Institute
Cherokee, IA 51012-1573 - Phone
- (712) 225-2594
- Fax
- (712) 225-6956
- NPI assigned
- Mar 2, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080730000618 | IA | Practitioner - Physician Assistant | 7315011905 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001779 | IA | MD | Registered Dietitian |
| 1779 | IA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boone County Hospital | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1779 | IA | Yes |
Addresses
Primary practice location
1200 W Cedar Loop
Cherokee Mental Health Institute
Cherokee, IA 51012-1573
Mailing address
1214 W Cedar Loop
Cherokee, IA 51012-1573
Phone (712) 225-2594
Other providers in Cherokee, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.