Individual provider Active NPI

Randolph Marshall Baker, MD

  • Internal Medicine Physician
  • Palmyra, VA
National Provider Identifier
1265448310
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101259557 Issued in VA
Practice address
33 Rebecca Dr
Palmyra, VA 22963-6242
Phone
(434) 654-4680
Fax
(434) 589-6688
NPI assigned
Jul 31, 2006
Last updated
Nov 30, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101259557 VA Primary

Addresses

Primary practice location

33 Rebecca Dr
Palmyra, VA 22963-6242

Mailing address

PO Box 79777
Baltimore, MD 21279-0777
Phone (434) 654-7794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101018000426 GA Practitioner - Internal Medicine 3072706522 Reassigns benefits to 1 organization
I20161004001673 VA Practitioner - Internal Medicine 3072706522 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Martha Jefferson Medical Group LLCGroup PAC ID 5991889081, 197 clinicians

Practice addresses (Care Compare)

33 Rebecca Dr
Palmyra, VA 22963-6242
Phone (434) 654-4680

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Medical Group LLC Internal Medicine CurrentSince Oct 15, 2016 Accepting new patients
Cooperative Healthcare Services Inc Internal Medicine CurrentSince Mar 1, 2014 Accepting new patients
Summit Internal Medicine Internal Medicine PastSince Apr 1, 1999 Accepting new patients

Locations

1111 Glynco Pkwy
Ste 30
Brunswick, GA 31525
Phone (912) 267-1026

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

33 Rebecca Dr
Palmyra, VA 22963
Phone (434) 654-4680

Interoperability endpoints

  • Direct secure messaging: rbaker253853@direct.sentara.net

Organizations & group practices 3

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1265448310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79777",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790777",
            "telephone_number": "434-654-7794",
            "fax_number": "434-654-7752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 REBECCA DR",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229636242",
            "telephone_number": "434-654-4680",
            "fax_number": "434-589-6688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "RANDOLPH",
        "middle_name": "MARSHALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101259557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmyra, VA

Sources for this page

Verify at the official NPI Registry.