John V. Baka M.D.P.a

Primary specialty

SpecialistTaxonomy code 174400000X

License

E0792 Issued in AR

Legal business name

JOHN V. BAKA M.D.P.A

Practice address

1220 Military Rd
Benton, AR 72015-2908

Phone

(501) 778-1000

Fax

(501) 778-1010

NPI assigned

Jul 13, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Vincent Baka, M.D.NPI 1083633366

Title

Physician

Phone

(501) 778-1000

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Benton Women's Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Vincent Baka, M.D.

  • Specialist
  • Benton, AR
  • NPI 1083633366
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295827200000",
    "number": "1023033859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720180604",
            "telephone_number": "501-778-1000",
            "fax_number": "501-778-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 MILITARY RD",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720152908",
            "telephone_number": "501-778-1000",
            "fax_number": "501-778-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN V. BAKA M.D.P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2011-01-24",
        "status": "A",
        "authorized_official_last_name": "BAKA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "VINCENT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "501-778-1000",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "AR",
            "license": "E0792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QC",
            "identifier": "16839000000",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137424002",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5K157",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benton Women's Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lucille Jerry, RECOVERY ASSISTANT
• Autumn N Jessen, COTA
• JLM Ventures, Inc.
• JLM Ventures, Inc.
• JM Psychiatry PLLC
• Erika Johninson, RECOVERY ASSISTANT
• Rosalind Johnson-Reams, RECOVERY ASSISTANT
• Briggette G Johnson, REGISTERED NURSE
• Bryisha Johnson, RECOVERY ASSISTANT
• Carrie Anne Johnson, MPT

• Specialist in Benton, AR
• Providers in Benton, AR by specialty
• Specialist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.