Active NPI
Kevin Anthony Baumer, M.D.
- Orthopaedic Surgery Physician
- Belleville, IL
National Provider Identifier
1891799565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 036090101
- Practice address
- 4700 Memorial Dr
Ste 340
Belleville, IL 62226-5373 - Phone
- (618) 234-9884
- Fax
- (618) 235-9020
- NPI assigned
- Jun 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 036090101 | IL | Primary |
Addresses
Primary practice location
4700 Memorial Dr
Ste 340
Belleville, IL 62226-5373
Mailing address
4700 Memorial Dr
Ste 340
Belleville, IL 62226-5373
Phone (618) 234-9884
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036090101 | Medicaid | IL | |
| 1891799565 | Medicaid | IL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- kbaumer170897@direct.carenet.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612483200000",
"number": "1891799565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 MEMORIAL DR",
"address_2": "STE 340",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265373",
"telephone_number": "618-234-9884",
"fax_number": "618-235-9020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 MEMORIAL DR",
"address_2": "STE 340",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265373",
"telephone_number": "618-234-9884",
"fax_number": "618-235-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUMER",
"first_name": "KEVIN",
"middle_name": "ANTHONY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-09",
"last_updated": "2021-02-05",
"certification_date": "2021-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "IL",
"license": "036090101",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036090101",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891799565",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "BJC",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4700 Memorial Dr",
"address_2": "Ste 340",
"city": "Belleville",
"state": "IL",
"country_code": "US",
"postal_code": "622265373",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.