NPIMap

Individual provider Active NPI

Everett Vincent Baker, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1154746261
Registry record updated Dec 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18364 Issued in TN
Practice address
2410 Susannah St
Johnson City, TN 37601-1748
Phone
(423) 282-9011
Fax
(423) 722-0291
NPI assigned
Feb 26, 2014
Sex
Male
Sole proprietor
No

Organizations & group practices 9

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Watauga Orthopaedics PLC 85 clinicians
Champion Physical Therapy LLC Halls 277 clinicians

Practice addresses (Care Compare)

2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011

420 Railroad St
Elizabethton, TN 37643-2504
Phone (423) 297-1813

Hospital & facility affiliations

  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017
  • Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012
  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063
  • Greeneville Community Hospital Hospital, Greeneville, TN, CCN 440050
  • Franklin Woods Community Hospital Hospital, Johnson City, TN, CCN 440184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140430001825 TN Practitioner - Nurse Practitioner 7810120755 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
18364TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Watauga Orthopaedics PLC Family CurrentSince Feb 25, 2014 Accepting new patients
Watauga Orthopaedics, PLC CurrentSince Feb 25, 2014 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2410 Susannah St
Johnson City, TN 37601
Phone (423) 282-9011

875 Larry Neil Way
Kingsport, TN 37660
Phone (423) 282-9011

Interoperability endpoints

  • Direct secure messaging: everett.baker.1@3374.direct.athenahealth.com

NPPES NPI Registry

Updated by the provider on Dec 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18364 TN Primary

Addresses

Primary practice location

2410 Susannah St
Johnson City, TN 37601-1748

Mailing address

2410 Susannah St
Johnson City, TN 37601-1748
Phone (423) 282-9011

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 17, 2019.

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576540800000",
    "number": "1154746261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011",
            "fax_number": "423-722-0291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011",
            "fax_number": "423-722-0291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "EVERETT",
        "middle_name": "VINCENT",
        "name_prefix": "Mr.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-26",
        "last_updated": "2019-12-17",
        "certification_date": "2019-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.