Individual provider Active NPI

Marie-Blanche Tatkeu Baker

  • Psychiatric/Mental Health Nurse Practitioner
  • Washington, DC
National Provider Identifier
1306558465
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP1038654 Issued in DC
Practice address
1715 Newton St NE
Washington, DC 20018-2319
Phone
(202) 526-1675
NPI assigned
Dec 21, 2022
Last updated
Dec 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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 Nurse Practitioner 363LP0808X NP1038654 DC Primary

Addresses

Primary practice location

1715 Newton St NE
Washington, DC 20018-2319

Mailing address

13805 Dawn Whistle Way
Bowie, MD 20721-1226
Phone (443) 454-4234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20230824001707 MD Practitioner - Nurse Practitioner 7618330689 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP1038654DCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Psychiatric Services LLC Psychiatric/Mental Health CurrentSince Jul 14, 2023 Accepting new patients
Goshen Healthcare & Management Services PastSince Dec 28, 2022 Accepting new patients

Locations

100 E Patapsco Ave
Brooklyn, MD 21225
Phone (667) 231-0317

601 E Naylor Mill Rd
Unit F
Salisbury, MD 21804
Phone (410) 546-4659

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": "1671580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1306558465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13805 DAWN WHISTLE WAY",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207211226",
            "telephone_number": "443-454-4234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 NEWTON ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200182319",
            "telephone_number": "202-526-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "MARIE-BLANCHE",
        "middle_name": "TATKEU",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-21",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DC",
            "license": "NP1038654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.