NPIMap

Organization Active NPI

Jerry L Baker OD

  • Optometrist
  • Rome, NY
National Provider Identifier
1154508356
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TUV003219 Issued in NY
Legal business name
JERRY L BAKER OD
Practice address
1300 Floyd Ave
Suite 1
Rome, NY 13440-4600
Phone
(315) 337-3277
Fax
(315) 336-8160
NPI assigned
Jan 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Authorized official

Name
Jerry L Baker, ODNPI 1669463386
Title
Owner
Phone
(315) 337-3277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TUV003219 NY Primary

Addresses

Primary practice location

1300 Floyd Ave
Suite 1
Rome, NY 13440-4600

Mailing address

1300 Floyd Ave
Suite 1
Rome, NY 13440-4600
Phone (315) 337-3277

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1154508356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 FLOYD AVE",
            "address_2": "SUITE 1",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134404600",
            "telephone_number": "315-337-3277",
            "fax_number": "315-336-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 FLOYD AVE",
            "address_2": "SUITE 1",
            "city": "ROME",
            "state": "NY",
            "postal_code": "134404600",
            "telephone_number": "315-337-3277",
            "fax_number": "315-336-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY L BAKER OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-337-3277",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV003219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.