Kathie Baldwin – Community Health Worker in Homer, AK

Key facts

NPI: 1053912865
Entity type: Individual (NPI type 1)
Primary specialty: Community Health Worker 172V00000X
Practice address: 3948 Ben Walters LN
Homer, AK 99603-7708
Phone: (907) 235-7701
NPI assigned: Nov 6, 2020
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Community Health Worker	172V00000X			Yes

Addresses

Primary practice location

3948 Ben Walters LN
Homer, AK 99603-7708

Mailing address

3948 Ben Walters LN
Homer, AK 99603-7708
Phone (907) 235-7701

Other identifiers

Identifier	Type	State	Issuer
1020987	Medicaid	AK

Electronic endpoints

Type	Endpoint	Use	Affiliation
Direct Messaging Address	kbaldwin@spbhs.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 10, 2020.

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1053912865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3948 BEN WALTERS LN",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037708",
            "telephone_number": "907-235-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3948 BEN WALTERS LN",
            "city": "HOMER",
            "state": "AK",
            "postal_code": "996037708",
            "telephone_number": "907-235-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "KATHIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020987",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbaldwin@spbhs.org",
            "affiliation": "N",
            "address_1": "3948 Ben Walters Ln",
            "city": "Homer",
            "state": "AK",
            "country_code": "US",
            "postal_code": "996037708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Homer, AK

All providers in Homer, AK · Community Health Worker in Alaska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.