Individual provider Active NPI

Juanita Belle Bauman, D.O

  • Family Medicine Physician
  • Queenstown, MD
National Provider Identifier
1871587568
Registry record updated Sep 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C2-0009822 Issued in DE
Practice address
317 Overlook Drive
Queenstown, MD 21658-1262
Phone
(410) 746-8664
NPI assigned
Sep 8, 2005
Last updated
Sep 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H36245 MD
Family Medicine Physician 207Q00000X C2-0009822 DE Primary

Addresses

Primary practice location

317 Overlook Drive
Queenstown, MD 21658-1262

Mailing address

317 Overlook Drive
Queenstown, MD 21658-1262
Phone (410) 746-8664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
C2-0009822DEMDFamily Medicine Physician
H36245MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Padder Health Services, LLC Family Medicine Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFEBAA

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379635200000",
    "number": "1871587568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 OVERLOOK DRIVE",
            "city": "QUEENSTOWN",
            "state": "MD",
            "postal_code": "216581262",
            "telephone_number": "410-746-8664",
            "fax_number": "302-934-7875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 OVERLOOK DRIVE",
            "city": "QUEENSTOWN",
            "state": "MD",
            "postal_code": "216581262",
            "telephone_number": "410-746-8664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMAN",
        "first_name": "JUANITA",
        "middle_name": "BELLE",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-08",
        "last_updated": "2013-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H36245",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C2-0009822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queenstown, MD

Sources for this page

Verify at the official NPI Registry.