Individual provider Active NPI

Benjamin Baker Jr.

  • Adult Health Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1104212869
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN202254 Issued in GA
Practice address
600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone
(770) 400-6000
NPI assigned
Apr 9, 2015
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN202254 GA Primary

Addresses

Primary practice location

600 Celebrate Life Pkwy
Newnan, GA 30265-8001

Mailing address

600 Celebrate Life Pkwy
Newnan, GA 30265-8001
Phone (770) 400-6000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ctcasermc@ctcaallscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160908001685 GA Practitioner - Nurse Practitioner 4385930924 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
City of Hope Medical Group of Georgia LLC CurrentSince Jul 13, 2016 Accepting new patients
Cogent Healthcare of Georgia PC CurrentSince Jan 1, 2021 Accepting new patients
Georgia Mso LLC CurrentSince Apr 15, 2025 Accepting new patients
Hardy Renew Wellness,LLC CurrentSince Nov 10, 2022 Accepting new patients
Internal Medicine of Griffin Past Accepting new patients
Laboratory Corporation of America Holdings Past Accepting new patients

Locations

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

1640 Powers Ferry Rd SE
Bldg 15
Marietta, GA 30067
Phone (770) 722-9595

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

62742 Collections Ctr Dr
Chicago, IL 60693

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1104212869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658001",
            "telephone_number": "770-400-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CELEBRATE LIFE PKWY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302658001",
            "telephone_number": "770-400-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "BENJAMIN",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN202254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctcasermc@ctcaallscriptsdirect.net",
            "affiliation": "N",
            "address_1": "600 Celebrate Life Pkwy",
            "city": "Newnan",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302658001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.