Anthony Eugene Baldacci, M.S.N., ANP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

200850023NP Issued in OR

Practice address

1836 Meade Street
North Bend, OR 97459

Phone

(541) 808-0430

NPI assigned

Dec 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Tony Baldacci Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1902080013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 MEADE STREET",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "97459",
            "telephone_number": "541-808-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1836 MEADE STREET",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "97459",
            "telephone_number": "541-808-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDACCI",
        "first_name": "ANTHONY",
        "middle_name": "EUGENE",
        "name_prefix": "Mr.",
        "credential": "M.S.N., ANP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-26",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "648845",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200742895RN",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "200850023NP",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CA",
            "license": "18025",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "R120353",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213342",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINIC GROUP NPI",
            "identifier": "1619915113",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONY",
            "last_name": "BALDACCI",
            "credential": "M.S.N., ANP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kathleen B Azab, QMHP, MS
• Cato Jeanette Badenhorst, RPH
• Devin Jon Bailey-Wilson, PSS
• Sally Baird-Scott, QMHA
• Hannah Grace Baker, L.M.T.
• Annalee Balkema
• Kayla R Barcklay, CRM
• Cynthia Lynn Bartell, LMT
• Michael Patrick Bartell, D.C.
• Jennifer Barton, CADC-R

• Adult Health Nurse Practitioner in North Bend, OR
• Providers in North Bend, OR by specialty
• Adult Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.