MADELYN A BAUCUM (NPI# 1548785850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548785850 |
| Entity Type | Individual |
| Full Name | MADELYN A BAUCUM |
| Credential | PA |
| Practice Address |
1220 Jefferson St Laurel MS 39440-4355 |
| Mailing Address |
Po Box 247 Laurel MS 39441-0247 |
| Practice Telephone | 6014264000 |
| Practice Fax Number | 6014264105 |
| Mailing Telephone | 6013996169 |
| Mailing Fax Number | 6013996262 |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2017-08-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA00335 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1220 JEFFERSON ST |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619973542 | South Central Regional Medical Center | General Acute Care Hospital | 1220 Jefferson St, Laurel, MS 39440-4355 | 2005-06-24 |
| 1730799578 | Holly Marie White | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2020-08-06 |
| 1407495492 | David Caldwell | Physician Assistant | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-12-23 |
| 1659918084 | Elizabeth Allen | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-12-04 |
| 1598300626 | Nicole Nielsen | Physical Therapist | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-11-13 |
| 1437793163 | Marty Jacob Brock | Physical Therapist | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-11-06 |
| 1881253557 | Sarah M Wooten | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-06-06 |
| 1730742933 | Hanna Rae Mccoy | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-04-15 |
| 1801372685 | Anna Seals | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440-4355 | 2018-07-16 |
| 1982195137 | Erica Windham | Nurse Practitioner | 1220 Jefferson St, Laurel, MS 39440 | 2018-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710520390 | Karla Valle Ponton | Physician Assistant | 10406 Leslie Dr, Laurel, MD 20723-1272 | 2019-10-25 |
| 1295377752 | Angelica Rose Giuliani | Physician Assistant | 15605 Straughn Dr, Laurel, MD 20707-2658 | 2019-10-16 |
| 1689229403 | Adanna Hackett | Physician Assistant | 7350 Van Dusen Rd # 2617, Laurel, MD 20707-5263 | 2019-08-08 |
| 1881160091 | Thomas Kevin Phelan Jr. | Physician Assistant | 12112 Mount Pleasant Dr, Laurel, MD 20708-2527 | 2018-10-16 |
| 1831537349 | Mihail Rimbu | Physician Assistant | 7850 Contee Rd, Ap 470, Laurel, MD 20707 | 2013-06-06 |
| 1467732255 | Krutiben V Patel | Physician Assistant | 9811 Mallard Dr Ste 118, Laurel, MD 20708-3180 | 2011-08-24 |
| 1407495492 | David Caldwell | Physician Assistant | 1220 Jefferson St, Laurel, MS 39440-4355 | 2019-12-23 |
| 1922583335 | Sarah Joy Cavaliere | Physician Assistant | 3357b Corridor Marketplace, Laurel, MD 20724 | 2018-10-02 |
| 1710487459 | Moustapha Drame | Physician Assistant | 3450 Laurel Fort Meade Rd, Laurel, MD 20724-2040 | 2018-02-20 |
| 1689038341 | Southern Emergency Medicine, LLC | Physician Assistant | 7300 Van Dusen Rd, Laurel, MD 20707-9463 | 2016-04-08 |
| Find all providers in LAUREL | ||||
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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.