Organization Active NPI

Bay Area ENT, PLLC

  • Specialist
  • Ocean Springs, MS
National Provider Identifier
1851324776
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
BAY AREA ENT, PLLC
Practice address
1137 Ocean Springs Rd
Ocean Springs, MS 39564-3421
Phone
(228) 875-8291
Fax
(877) 504-3044
NPI assigned
Jul 7, 2006
Last updated
Oct 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Authorized official

Name
Andrea D Bakker
Title
Administrator
Phone
(228) 314-2624

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

1137 Ocean Springs Rd
Ocean Springs, MS 39564-3421

Mailing address

1137 Ocean Springs Rd
Ocean Springs, MS 39564-3421
Phone (228) 875-8291

Other identifiers 1

IdentifierTypeStateIssuer
9015470MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060313000611 MS Part B Supplier - Clinic/Group Practice 1153338330 Receives reassigned benefits from 4 practitioners
Practice locations: Ocean Springs, MS

National Provider Directory

National Provider Directory

Locations

1137 Ocean Springs Rd
Ocean Springs, MS 39564
Phone (228) 875-8291

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444867200000",
    "number": "1851324776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 OCEAN SPRINGS RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643421",
            "telephone_number": "228-875-8291",
            "fax_number": "877-504-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 OCEAN SPRINGS RD",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643421",
            "telephone_number": "228-875-8291",
            "fax_number": "877-504-3044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY AREA ENT, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2015-10-15",
        "status": "A",
        "authorized_official_last_name": "BAKKER",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "228-314-2624"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9015470",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.