Cynthia L Bauman, NP
Individual provider Active NPI Nurse Practitioner · Ogden, UT
NPI 1770530495 · NPPES record last updated Jul 29, 2008
Key facts
- NPI
- 1770530495
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 212323-4405 (UT)
- Practice address
- 4403 Harrison Blvd
Ste #3490
Ogden, UT 84403-3271 - Phone
- (801) 387-2650
- Fax
- (801) 387-2655
- NPI assigned
- May 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- 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 |
|---|---|---|---|---|
| I20051222000176 | UT | Practitioner - Nurse Practitioner | 2163401290 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 212323-4405 | UT | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Nurse Practitioner | Current | Accepting new patients |
| Ihc Health Services Inc | Current |
Accepting new patients | |
| Ihc Health Services, Inc. | Current |
Accepting new patients | |
| Revere Health PC | Past | Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
4403 Harrison Blvd
Ste 3490
Ogden, UT 84403
Phone (801) 387-2650
4403 Harrison Blvd
Ste 3630
Ogden, UT 84403
Phone (801) 387-7900
4401 Harrison Blvd
South Ogden, UT 84403
Phone (801) 387-2800
1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992
1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355
3930 W Parkway Blvd
West Valley City, UT 84120
Phone (435) 462-2441
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 212323-4405 | UT | Yes |
Addresses
Primary practice location
4403 Harrison Blvd
Ste #3490
Ogden, UT 84403-3271
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 387-2650
Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2008. 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.