Individual provider Active NPI

Maura A Bauman, PAC

  • Surgical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1811917248
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
001367 Issued in GA
Practice address
975 Johnson Ferry Rd NE
Ste 500
Atlanta, GA 30342-1619
Phone
(404) 256-1311
Fax
(404) 250-3388
NPI assigned
Jul 20, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 001367 GA Primary

Addresses

Primary practice location

975 Johnson Ferry Rd NE
Ste 500
Atlanta, GA 30342-1619

Mailing address

975 Johnson Ferry Rd NE
Ste 500
Atlanta, GA 30342-1619
Phone (404) 256-1311

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1367GAMDPediatrics Physician
001367GAMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811917248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 JOHNSON FERRY RD NE",
            "address_2": "STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421619",
            "telephone_number": "404-256-1311",
            "fax_number": "404-250-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 JOHNSON FERRY RD NE",
            "address_2": "STE 500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421619",
            "telephone_number": "404-256-1311",
            "fax_number": "404-250-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMAN",
        "first_name": "MAURA",
        "middle_name": "A",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "001367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.