Active NPI
Laci Lynn Baurer, ATC
- Athletic Trainer
- Magnolia, AR
National Provider Identifier
1992147300
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT 431
- Practice address
- 100 East University
Magnolia, AR 71754 - Phone
- (870) 235-5229
- Fax
- (870) 235-4988
- NPI assigned
- Jul 26, 2013
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT 431 | AR | Primary |
Addresses
Primary practice location
100 East University
Magnolia, AR 71754
Mailing address
502 Warnock Springs Rd
Magnolia, AR 71753
Phone (501) 416-3876
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 090202032 | Other | BOARD OF CERTIFICATION NUMBER |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT 431 | AR | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Arkansas University | Past | Accepting new patients |
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.
-
dba Southern Arkansas University Sports Medicine
- Sports Medicine (Family Medicine) Physician
- Magnolia, AR
- NPI 1144623679
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374796800000",
"number": "1992147300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 WARNOCK SPRINGS RD",
"city": "MAGNOLIA",
"state": "AR",
"postal_code": "71753",
"telephone_number": "501-416-3876",
"fax_number": "870-235-4988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 EAST UNIVERSITY",
"city": "MAGNOLIA",
"state": "AR",
"postal_code": "71754",
"telephone_number": "870-235-5229",
"fax_number": "870-235-4988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAURER",
"first_name": "LACI",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-26",
"last_updated": "2013-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AR",
"license": "AT 431",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF CERTIFICATION NUMBER",
"identifier": "090202032",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Magnolia, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.