Bonnie Smithyman Baird, DC CCSP

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

1670NC Issued in NC

Practice address

320 N Judd Prkwy NE
Ste 102
Fuquay Varina, NC 27526

Phone

(919) 557-5811

Fax

(919) 557-8236

NPI assigned

Nov 30, 2006

Sex

Female

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1891862025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 N JUDD PRKWY NE",
            "address_2": "STE 102",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "27526",
            "telephone_number": "919-557-5811",
            "fax_number": "919-557-8236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 N JUDD PRKWY NE",
            "address_2": "STE 102",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "27526",
            "telephone_number": "919-557-5811",
            "fax_number": "919-557-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIRD",
        "first_name": "BONNIE",
        "middle_name": "SMITHYMAN",
        "name_prefix": "Dr.",
        "credential": "DC CCSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NC",
            "license": "1670NC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0809A",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "330573",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6320398",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tammy Baccus, PTA, DOR
• Back in Action Inc (Back in Action Physical Therapy)
• Odette Berinyuy Bagob, RN
• Donald Lee Bailey Jr., D.D.S.
• Baird Chiropractic Inc
• Jessica Baker
• Nicole Andra Baker, LCMHC
• Tammi Jean Baldisserotto, OTR/L
• James Bruce Baldwin, OD
• Danela Dorine Balentin, M.A, LPCA

• Sports Physician Chiropractor in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Sports Physician Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.