Jesse Blake Bauer

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

227135 Issued in NC

Practice address

1300 Miccosukee Rd
Tallahassee, FL 32308-5054

Phone

(850) 431-0911

NPI assigned

Mar 27, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Jesse Blake Cogburn Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

TMH Emergency Physician GroupGroup PAC ID 8325317084, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tallahassee Memorial Healthcare Hospital, Tallahassee, FL, CCN 100135

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbauer21813@tallahasseememorial.direct-ci.com

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.

• TMH Emergency Physician Group

  • Emergency Medicine Physician
  • Tallahassee, FL
  • NPI 1417483819
  Medicare reassignment Care Compare group NPD
• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Medicare reassignment NPD
• Tallahassee Memorial Healthcare Inc

  • Hospitalist Physician
  • Tallahassee, FL
  • NPI 1194774968
  NPD
• Tallahassee Memorial Healthcare Inc

  • Family Medicine Physician
  • Tallahassee, FL
  • NPI 1366293102
  NPD
• TMH Emergency Physician Group

  • Emergency Medicine Physician
  • Tallahassee, FL
  • NPI 1235665605
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Tallahassee Memorial Healthcare Inc

  • General Acute Care Hospital
  • Tallahassee, FL
  • NPI 1437177664
  Care Compare affiliation

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1871024117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 SAINT JAMES CT STE 1",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085352",
            "telephone_number": "850-431-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MICCOSUKEE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085054",
            "telephone_number": "850-431-0911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Blythe Blvd",
            "address_2": "Department of Emergency Medicine",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-3181",
            "fax_number": "704-355-7047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUER",
        "first_name": "JESSE",
        "middle_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME145248",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "227135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSE",
            "last_name": "COGBURN",
            "middle_name": "BLAKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lynette Battles, ARNP, PMHNP-BC
• Patricia Lauren Battles
• Jessica Baucom
• Aurora B Baucum
• Frederick Jean Baudoin D'Ajoux, RN
• Kristy Lynn Bauer, MSW
• Alton Locksley Baugh Jr., PHARMD
• Bruce Ashley Baumann
• Jon M Baumbauer, DDS
• Venkata V Bavikati, MBBS, MPH

• Emergency Medicine Physician in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.