Individual provider Active NPI

Carol Dean Baker, PMH, CNS

  • Psychiatric/Mental Health Clinical Nurse Specialist
  • Macon, GA
National Provider Identifier
1306277991
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X
License
RN057106 Issued in GA
Practice address
175 Emery Hwy
Macon, GA 31217-3692
Phone
(478) 803-7600
Fax
(478) 803-8596
NPI assigned
Dec 6, 2013
Last updated
Aug 27, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Clinical Nurse Specialist 364SP0808X RN057106 GA Primary

Addresses

Primary practice location

175 Emery Hwy
Macon, GA 31217-3692

Mailing address

175 Emery Hwy
Macon, GA 31217-3692
Phone (478) 803-7631

Other practice location 1

3575 Fulton Mill Rd
Macon, GA 31206-5125
Phone (478) 803-8617

Other practice location 2

168 Old Brent Rd
Forsyth, GA 31029-6911
Phone (478) 803-7837

Other identifiers 1

IdentifierTypeStateIssuer
RN057106OtherGAPMHCNS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
RN057106GAMDPsychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
River Edge Behavioral Health Center Past Accepting new patients
River Edge Behavioral Health Center Past Accepting new patients

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": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1306277991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 EMERY HWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173692",
            "telephone_number": "478-803-7631",
            "fax_number": "478-751-4530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 EMERY HWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173692",
            "telephone_number": "478-803-7600",
            "fax_number": "478-803-8596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3575 Fulton Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312065125",
            "country_code": "US",
            "telephone_number": "478-803-8617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "168 Old Brent Rd",
            "address_purpose": "LOCATION",
            "city": "Forsyth",
            "state": "GA",
            "postal_code": "310296911",
            "country_code": "US",
            "telephone_number": "478-803-7837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "CAROL",
        "middle_name": "DEAN",
        "credential": "PMH, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN057106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMHCNS",
            "identifier": "RN057106",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.