Jennifer Ann Bauder, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

P160453764 Issued in WA

Practice address

1221 Mercantile LN
Upper Marlboro, MD 20774-5374

Phone

(301) 386-6770

NPI assigned

Jan 6, 2016

Last updated

Jan 6, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452038400000",
    "number": "1811353899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7416 NIGH RD",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220431308",
            "telephone_number": "509-280-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MERCANTILE LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745374",
            "telephone_number": "301-386-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUDER",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2016-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WA",
            "license": "P160453764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Physical Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.