Brady Baker, PA-C
Individual provider Active NPI Physician Assistant · Crestview Hills, KY
NPI 1225601446 · NPPES record last updated May 24, 2023
Key facts
- NPI
- 1225601446
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA2794 (KY)
- Practice address
- 2865 Chancellor Dr Ste 225
Crestview Hills, KY 41017-3915 - Phone
- (859) 341-5400
- NPI assigned
- Jul 24, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2794 | KY | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Associates PSC | Pediatrics | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | PA2794 | KY | |
| Physician Assistant | 363A00000X | PA2794 | KY | Yes |
Addresses
Primary practice location
2865 Chancellor Dr Ste 225
Crestview Hills, KY 41017-3915
Mailing address
2865 Chancellor Dr Ste 225
Crestview Hills, KY 41017-3915
Phone (859) 341-5400
Other providers in Crestview Hills, KY
- Tiffany Ashley
- Ati Cpap Solutions
- Atria Senior Living Group, Inc
- Joseph D Bailey IV
- Steven C Bailey
- Doris R. Bankston
- Krista Barnett
- Ruth Ellen Barone
- Raymond Curtis Bartholomew III
- Dallas Scott Basham
All providers in Crestview Hills, KY · Physician Assistant in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.