John Mark Bauer, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD00017301 Issued in WA

Practice address

304 W Bay Dr NW
Suite 301
Olympia, WA 98502-4958

Phone

(360) 413-8760

Fax

(360) 413-8839

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dr. Mark Bauer Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1851391015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 W BAY DR NW",
            "address_2": "SUITE 301",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024958",
            "telephone_number": "360-413-8760",
            "fax_number": "360-413-8839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W BAY DR NW",
            "address_2": "SUITE 301",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985024958",
            "telephone_number": "360-413-8760",
            "fax_number": "360-413-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "JOHN",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00017301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8214603",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GAB20353",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "BAUER",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Maaike Batey
• Param K Bath
• Suneet Singh Bath, DMD
• Jessica Lynn Batson, LMT
• Jacob Howard Bauer, M.D.
• Laura Flores Bauleke, MD
• Roxanne Bauman, MD
• Tracie Bauman, LMP
• Katherine Lynnette Bautista
• Patricia M Baxer, ARNP

• Dermatology Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.