| NPI Number | 1548884380 |
| Provider Name | Mckenzie Ann Bauman |
| Credential | |
| Specialization | |
| Medical School Name | Other |
| Graduation Year | 2021 |
| Gender | F |
| Entity Type | Individual |
| PAC ID by PECOS | 3678961943 |
| Professional Enrollment ID | I20211020000141 |
| Enumeration Date | 06/06/2020 |
| Last Update Date | 06/07/2021 |
| Business Practice address |
25022 MATTON GROVE CHURCH RD, Gold Hill, 28071-6641 North Carolina View on Google Map |
| Business Practice phone | 704-305-2911 |
| Business Practice fax | |
| Mailing address |
PO BOX 997, Boiling Springs, 28017-0997 North Carolina View on Google Map |
| Other phone | 704-406-4000 |
| Other fax | |
| Email Address | shannonfig@domain.com Reval Email Address |
Carolinas Medical Center-Northeast in Gold Hill
Gold Hill, North Carolina
Other
2021
| Organization Name | PECOS PAC ID | Members | |
|---|---|---|---|
|
Cabarrus Gastroenterology Associates, Pllc | 9436059649 | 35 |
| Field Name | Field Value |
|---|---|
| NPI | 1548884380 |
| 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. | |
| Entity Type | Individual |
Code describing the type of health care provider that is being assigned an NPI. Codes are:
|
|
| Is Sole Proprietor | N |
Indicate whether provider is a sole proprietor.
|
|
| Provider Last Name (Legal Name) | Bauman |
| The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. | |
| Provider First Name | Mckenzie |
| The first name of the provider, if the provider is an individual. | |
| Provider Credential Text | |
| The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS. | |
| Provider First Line Business Mailing Address | PO BOX 997 |
| The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''. | |
| Provider Business Mailing Address City Name | Boiling Springs |
| The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''. | |
| Provider Business Mailing Address State Name | North Carolina |
| The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''. | |
| Provider Business Mailing Address Postal Code | 28017-0997 |
| The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''. | |
| Provider Business Mailing Address Country Code | US |
| The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''. | |
| Provider Business Mailing Address Telephone Number | 704-406-4000 |
| The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''. | |
| Provider First Line Business Practice Location Address | 25022 MATTON GROVE CHURCH RD |
| The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. | |
| Provider Business Practice Location Address City Name | Gold Hill |
| The city name in the location address of the provider being identified. | |
| Provider Business Practice Location Address State Name | North Carolina |
| The State or Province name in the location address of the provider being identified. | |
| Provider Business Practice Location Address Postal Code | 28071-6641 |
| The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. | |
| Provider Business Practice Location Address Country Code | US |
| The country code in the location address of the provider being identified. | |
| Provider Business Practice Location Address Telephone Number | 704-305-2911 |
| The telephone number associated with the location address of the provider being identified. | |
| Provider Enumeration Date | 06/06/2020 |
| The date the provider was assigned a unique identifier (assigned an NPI). | |
| Last Update Date | 06/07/2021 |
| The date that a record was last updated or changed. | |
| Provider Gender Code | F |
| The code designating the provider's gender if the provider is a person. | |
| Provider Gender | Female |
| The provider's gender if the provider is a person. | |
| Healthcare Provider Taxonomy Code #1 | 225200000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 1 | (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of the physical therapist assistant. The PTA performs physical therapy procedures and related tasks that have been selected and delegated by the supervising physical therapist. Duties of the PTA include assisting the physical therapist in implementing treatment programs, training patients in exercised and activities of daily living, conducting treatments, and reporting to the physical therapist on the patient's responses. In addition to direct patient care, the PTA may also perform such functions as patient transport, and clinic or equipment preparation and maintenance. Currently more than half of all states require PTAs to be licensed, registered or certified. (2) An individual who works under the supervision of a physical therapist to assist him or her in providing physical therapy services. A physical therapy assistant may, for instance, help patients follow an appropriate exercise program that will increase their strength, endurance, coordination, and range of motion and train patients to perform activities of daily life. |
| Healthcare Provider Taxonomy #1 | |
| Healthcare Provider Primary Taxonomy Switch 1 | N |
Primary Taxonomy:
|
|
| Healthcare Provider Taxonomy Code #2 | 363A00000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 2 | 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. |
| Healthcare Provider Taxonomy #2 | |
| Healthcare Provider Primary Taxonomy Switch 2 | Y |
Primary Taxonomy:
|
