DR. NICHOLAS BAUER


Address: 554 Keily Street, Centralized Credential and Privileging Directorate, Jacksonville, FL 32212
Phone: 7579537550

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).

Provider Overview

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

Taxonomy

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

Provider Secondary Practice Location

Address Telephone Number Fax Number
620 John Paul Jones Cir, Naval Medical Center Portsmouth, Portsmouth, VA 237082111 7579530669

Office Location

Street Address 554 KEILY STREET
CENTRALIZED CREDENTIAL AND PRIVILEGING DIRECTORATE
City JACKSONVILLE
State FL
Zip Code 32212

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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
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Competitor

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City JACKSONVILLE
Zip Code 32212

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Dataset Information

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.

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