Active NPI
Carol Dean Baker, PMH, CNS
- Psychiatric/Mental Health Clinical Nurse Specialist
- Macon, GA
National Provider Identifier
1306277991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Clinical Nurse Specialist
- License
- RN057106
- 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, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN057106 | Other | GA | PMHCNS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN057106 | GA | MD | Psychiatric/Mental Health Clinical Nurse Specialist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Community/Behavioral Health Agency
- Forsyth, GA
- NPI 1477612810
-
- Community/Behavioral Health Agency
- Forsyth, GA
- NPI 1578759320
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.