Tammy Baccus, PTA, DOR

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3943 Issued in NC

Practice address

1221 Broad St
Fuquay Varina, NC 27526-3602

Phone

(919) 424-5080

NPI assigned

Jun 9, 2021

Last updated

Jun 9, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1623196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1912574765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BERMUDA GREEN DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277032921",
            "telephone_number": "980-267-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 BROAD ST",
            "city": "FUQUAY VARINA",
            "state": "NC",
            "postal_code": "275263602",
            "telephone_number": "919-424-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACCUS",
        "first_name": "TAMMY",
        "credential": "PTA, DOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-09",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "3943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Authentic Hands Home Care, LLC
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• Ruby Carolina Avelar
• Justin Alden Ayre, LCSW, CAS-I
• Cynthia L Babits, LCSW
• Back in Action Inc (Back in Action Physical Therapy)
• Odette Berinyuy Bagob, RN
• Donald Lee Bailey Jr., D.D.S.
• Baird Chiropractic Inc
• Bonnie Smithyman Baird, DC CCSP

• Physical Therapy Assistant in Fuquay Varina, NC
• Providers in Fuquay Varina, NC by specialty
• Physical Therapy Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.

Verify at the official NPI Registry.