Individual provider Active NPI

Jodi Pederson Baker, OD

  • Optometrist
  • Guntersville, AL
National Provider Identifier
1205329653
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-E04 Issued in AL
Practice address
2024 Gunter Ave
Guntersville, AL 35976-2113
Phone
(256) 293-5181
NPI assigned
Jun 11, 2018
Last updated
Dec 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-E04 AL Primary

Addresses

Primary practice location

2024 Gunter Ave
Guntersville, AL 35976-2113

Mailing address

1015 Honeycomb Rd
Grant, AL 35747-9387

Other practice location 1

3030 Memorial Pkwy SW
Huntsville, AL 35801-5372
Phone (256) 883-8338

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200122003409 AL Practitioner - Optometry 8820423783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2024 Gunter Ave
Guntersville, AL 35976-2113
Phone (256) 293-5181

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-E04ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Eye Care, LLC Optometrist CurrentSince Nov 25, 2019 Accepting new patients
America's Best Contacts & Eyeglasses Past Accepting new patients

Locations

2024 Gunter Ave
Guntersville, AL 35976
Phone (256) 293-5181

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1205329653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 HONEYCOMB RD",
            "city": "GRANT",
            "state": "AL",
            "postal_code": "357479387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 GUNTER AVE",
            "city": "GUNTERSVILLE",
            "state": "AL",
            "postal_code": "359762113",
            "telephone_number": "256-293-5181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3030 Memorial Pkwy SW",
            "address_purpose": "LOCATION",
            "city": "Huntsville",
            "state": "AL",
            "postal_code": "358015372",
            "country_code": "US",
            "telephone_number": "256-883-8338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "JODI",
        "middle_name": "PEDERSON",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E04",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guntersville, AL

Sources for this page

Verify at the official NPI Registry.