Izaiah Baker
Individual provider Active NPI Community Health Worker · Charleston, WV
NPI 1104401108 · NPPES record last updated Mar 11, 2021
Key facts
- NPI
- 1104401108
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 5303 Kanawha Ave SE
Charleston, WV 25304-2215 - Phone
- (304) 881-6570
- NPI assigned
- Mar 11, 2021
- Sex
- Male
- Sole proprietor
- Yes
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
5303 Kanawha Ave SE
Charleston, WV 25304-2215
Mailing address
5303 Kanawha Ave SE
Charleston, WV 25304-2215
Phone (304) 881-6570
Other providers in Charleston, WV
- Annmckenzie Baker
- Brittany Baker
- Chelsie Baker
- Dashawn Baker
- Dorian Baker
- Jacob Baker
- John Albert Baker Jr.
- Laura Baker
- Scott Allen Baker
- Shagara Baker
All providers in Charleston, WV · Community Health Worker in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2021. 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.