Individual provider Active NPI

Edward Baker, PH.D.

  • Clinical Psychologist
  • Morgantown, WV
National Provider Identifier
1104846757
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
797 Issued in WV
Practice address
1445 Stewartstown Rd Ste 200
Morgantown, WV 26505-3868
Phone
(304) 598-2300
Fax
(304) 598-2307
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 797 WV Primary

Addresses

Primary practice location

1445 Stewartstown Rd Ste 200
Morgantown, WV 26505-3868

Mailing address

1445 Stewartstown Rd Ste 200
Morgantown, WV 26505-3868
Phone (304) 598-2300

Other identifiers 2

IdentifierTypeStateIssuer
3810001400MedicaidWV
001716794OtherWVBC/BS (MOUNTAIN STATE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050105001129 WV Practitioner - Clinical Psychologist 3072561133 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fremouw Sigley and Baker Psychological Associates PLLCGroup PAC ID 1153584826, 3 clinicians

Practice addresses (Care Compare)

1445 Stewartstown Rd
Suite 200
Morgantown, WV 26505-3868
Phone (304) 598-2300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
797WVMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fremouw Sigley & Baker Psychological Associates PLLC Clinical CurrentSince Apr 15, 2012 Accepting new patients

Locations

167 Plaza Ct
Kingwood, WV 26537
Phone 30459823004

1224 Pineview Dr
Ste B
Morgantown, WV 26505
Phone (304) 298-2300

1445 Stewartstown Rd
Ste 200
Morgantown, WV 26505
Phone (304) 598-2300

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1104846757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 STEWARTSTOWN RD STE 200",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053868",
            "telephone_number": "304-598-2300",
            "fax_number": "304-598-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 STEWARTSTOWN RD STE 200",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265053868",
            "telephone_number": "304-598-2300",
            "fax_number": "304-598-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "EDWARD",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WV",
            "license": "797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001400",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS (MOUNTAIN STATE)",
            "identifier": "001716794",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.