Individual provider Active NPI

Raylee Baber, BSN, FNP-C

  • Family Nurse Practitioner
  • Weatherford, TX
National Provider Identifier
1235899683
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1094098 Issued in TX
Practice address
1709 Martin Dr. Suite 100
Weatherford, TX 76086
Phone
(817) 594-5880
NPI assigned
Dec 27, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 946585 TX
Family Nurse Practitioner 363LF0000X 1094098 TX Primary

Addresses

Primary practice location

1709 Martin Dr. Suite 100
Weatherford, TX 76086

Mailing address

11036 Kinston St
Fort Worth, TX 76179-5337
Phone (806) 893-2557

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221027000026 TX Practitioner - Nurse Practitioner 9739555111 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oliver Street 5.01(a) IncGroup PAC ID 0042464125, 169 clinicians

Practice addresses (Care Compare)

1709 Martin Dr
Suite 100
Weatherford, TX 76086-6738
Phone (817) 594-5880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
946585TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Oliver Street 5.01(a) Inc. CurrentSince Nov 1, 2022 Accepting new patients
Dermatology Associates PastSince Oct 16, 2022 Accepting new patients

Locations

805 S Palestine St
Athens, TX 75751
Phone (903) 534-6200

1334 S Palestine St
Athens, TX 75751
Phone (903) 579-7205

5310 Harvest Hill Rd
Ste 290
Dallas, TX 75230
Phone (214) 420-0672

203 Nacogdoches St
Ste 380
Jacksonville, TX 75766
Phone (903) 534-6200

1367 Dominion Plz
Tyler, TX 75703
Phone (903) 534-6200

1720 S Beckham Ave
Ste 102
Tyler, TX 75701
Phone (903) 534-6200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1235899683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11036 KINSTON ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761795337",
            "telephone_number": "806-893-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 MARTIN DR. SUITE 100",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "76086",
            "telephone_number": "817-594-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABER",
        "first_name": "RAYLEE",
        "name_prefix": "Mrs.",
        "credential": "BSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-27",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "946585",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1094098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

Verify at the official NPI Registry.