Individual provider Active NPI

Richard James Bakeman, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Augusta, GA
National Provider Identifier
1790717452
Registry record updated Jan 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN012002 Issued in GA
Practice address
1222 George C Wilson Dr
Augusta, GA 30909-4502
Phone
(706) 868-9500
Fax
(706) 868-5081
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN012002 GA Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 3793 SC

Addresses

Primary practice location

1222 George C Wilson Dr
Augusta, GA 30909-4502

Mailing address

1222 George C Wilson Dr
Augusta, GA 30909-4502
Phone (706) 868-9500

Other identifiers 4

IdentifierTypeStateIssuer
GRP5093OtherGAMEDICARE GROUP
00799565CMedicaidGA
ZG0276MedicaidSC
7561OtherSCMEDICARE GROUP

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2017 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Michigan Oral and Maxillofacial Surgery PC Oral and Maxillofacial Surgery PastSince Dec 1, 1991 Accepting new patients
Monarch Family Chiropractic LLC PastSince May 1, 2019 Accepting new patients
DRS Farrell, Farrell, Nale, Cook, Kapitan, Mohamed, Franco, Wessel, Ho Past Accepting new patients
Associates in Oral & Maxillofacial Surgery, PA Oral and Maxillofacial Surgery Past Accepting new patients
Faircloth and Bakeman Partnership Oral and Maxillofacial Surgery PastSince Jul 19, 2010 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1790717452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 GEORGE C WILSON DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094502",
            "telephone_number": "706-868-9500",
            "fax_number": "706-868-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1222 GEORGE C WILSON DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094502",
            "telephone_number": "706-868-9500",
            "fax_number": "706-868-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKEMAN",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "DN012002",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "3793",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "GRP5093",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00799565C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZG0276",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "7561",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.