DR. NICHOLAS BAUER (NPI# 1467818039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467818039 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS BAUER |
| Credential | MD, MHA |
| Practice Address |
554 Keily Street Centralized Credential and Privileging Directorate Jacksonville FL 32212 |
| Practice Telephone | 7579537550 |
| Practice Fax Number | 7579537560 |
| Mailing Telephone | 7579537550 |
| Mailing Fax Number | 7579537560 |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 0101262940 | VA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 620 John Paul Jones Cir, Naval Medical Center Portsmouth, Portsmouth, VA 237082111 | 7579530669 |
| Street Address |
554 KEILY STREET CENTRALIZED CREDENTIAL AND PRIVILEGING DIRECTORATE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326019373 | Brian G Norwood | Pediatrics | 554 Keily Street, Jacksonville, FL 32212 | 2006-01-29 |
| 1811461726 | Yocelin Hernandez Rojero | Occupational Therapist | 554 Keily Street, Jacksonville Fl 32212, Jacksonville, FL 32212 | 2019-01-14 |
| 1609381235 | Miranda Shilelagh Schmidt | Physician Assistant | 554 Keily Street, Jacksonville, FL 32212 | 2017-12-05 |
| 1144733627 | Tylisha Elyse Deshields | Social Worker | 554 Keily Street, Jacksonville, FL 32212 | 2017-11-07 |
| 1326557976 | David Michael Tatera | Psychologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-27 |
| 1104335348 | Kuang-hui Lee | General Practice | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-20 |
| 1548788177 | Sophia Renee Beal | Speech-Language Pathologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-04 |
| 1164949418 | George S Bennitt | Dentist | 554 Keily Street, Jacksonville, FL 32212-4047 | 2017-08-28 |
| 1124545389 | David Phillips | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Centralized Credential and Privileging Directorate, Jacksonville, FL 32212-2466 | 2017-08-28 |
| 1902323652 | Erich Chen | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Jacksonville, FL 32212 | 2017-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| Find all providers in zip 32212 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 1528680220 | Florida Injury & Regenerative Medicine, Pllc | General Practice | 8640 Philips Hwy Ste 10, Jacksonville, FL 32256-1208 | 2020-05-15 |
| 1689296808 | Sajid Khan Md LLC | General Practice | 4600 Touchton Rd E Ste 1150, Jacksonville, FL 32246-1542 | 2020-05-11 |
| 1396392767 | Yurelsy Galvez Ricardo | General Practice | 725 Middle Branch Way, Jacksonville, FL 32259-6201 | 2019-08-21 |
| 1639721772 | Deborah Brabham | General Practice | 10990 Lydia Estates Dr E, Jacksonville, FL 32218-6940 | 2019-07-09 |
| 1851868459 | Nursing On Demand Inc | General Practice | 1260 Mcduff Ave S # 3, Jacksonville, FL 32205-8030 | 2018-11-01 |
| 1295202984 | Summit Integrative Health, LLC | General Practice | 12627 San Jose Blvd Ste 305, Jacksonville, FL 32223-8639 | 2018-10-31 |
| 1558864736 | Andrew Louis Monroe | General Practice | As-100 White Street, Jacksonville, NC 28540 | 2018-03-14 |
| 1255859641 | Mcgowan Medical Centers, Pa | General Practice | 3021 N Main St, Jacksonville, FL 32206-2122 | 2017-09-06 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1700247863 | Emily Calhoun | General Practice | 554 Kelly Ln, Jacksonville, FL 32234-3049 | 2016-03-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.