Individual provider Active NPI

Jimmy Baughman

  • Licensed Practical Nurse
  • Anchorage, AK
National Provider Identifier
1679985014
Registry record updated May 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
5849 Issued in AK
Practice address
6002 Debarr Rd
Anchorage, AK 99504-2312
Phone
(907) 717-8133
NPI assigned
May 20, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 5849 AK Primary

Addresses

Primary practice location

6002 Debarr Rd
Anchorage, AK 99504-2312

Mailing address

6002 Debarr Rd
Anchorage, AK 99504-2312
Phone (907) 717-8133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5849AKMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1679985014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 DEBARR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995042312",
            "telephone_number": "907-717-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6002 DEBARR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995042312",
            "telephone_number": "907-717-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUGHMAN",
        "first_name": "JIMMY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AK",
            "license": "5849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.