Mark Baker, OD

Key facts

NPI

1124182282

Entity type

Individual (NPI type 1)

Primary specialty

Optometrist 152W00000X

License

1285 (TN)

Practice address

7600 Kingston Pike Ste 1110-a
Knoxville, TN 37919-5603

Phone

(865) 531-3295

Fax

(865) 531-8937

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 2

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.

• TN Doctors of Optometry, PLLC Optometrist · Collierville, TN · NPI 1538827050
  Medicare reassignment NPD OPTOMETRIST · TN
• TN Doctors of Optometry, PLLC Eyewear Supplier · Kingsport, TN · NPI 1275299562
  NPD OPTOMETRIST

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124182282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "SUITE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6663",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 KINGSTON PIKE STE 1110-A",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195603",
            "telephone_number": "865-531-3295",
            "fax_number": "865-531-8937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "MARK",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

• Katherine Baker
• Katherine C Baker, NP
• Kelly L Baker, MD
• Kristen Catherine Baker, M.S.
• Linda S Baker, CRNA
• Mark L Baker, CRNA
• Mary Patricia Baker, M.S. CCC-SLP
• Melissa Ann Baker, PT
• Mycah C Baker, PA-C
• Ruth Baker, M.S., CCC-SLP

All providers in Knoxville, TN · Optometrist in Tennessee