Dalton Dean Baker
Individual provider Active NPI Family Nurse Practitioner · Kirksville, MO
NPI 1326552191 · NPPES record last updated Sep 9, 2020
Key facts
- NPI
- 1326552191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- A149860 (IA)
- Practice address
- 512 N New St
Kirksville, MO 63501-3167 - Phone
- (660) 988-4723
- NPI assigned
- Nov 30, 2017
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kirksville Clinic Corp
Practice addresses (Care Compare)
315 S Osteopathy Ave
Kirksville, MO 63501-6401
Phone (660) 785-1000
800 W Jefferson St
Kirksville, MO 63501-1443
Phone (660) 626-2235
Hospital & facility affiliations
- Northeast Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.41 of 100
- Quality
- 79.26
- Promoting interoperability
- 100
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180918004401 | MO | Practitioner - Nurse Practitioner | 7517218381 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013022156 | MO | MD | Registered Nurse |
| A149860 | IA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kirksville Clinic Corp | Current |
Accepting new patients |
Locations
800 W Jefferson St
Kirksville, MO 63501
Phone (660) 626-2235
315 S Osteopathy Ave
Kirksville, MO 63501
Phone (660) 785-1000
1205 N Missouri St
Macon, MO 63552
Phone (660) 385-3151
Interoperability endpoints
- dalton.baker.1@2245.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2013022156 | MO | |
| Family Nurse Practitioner | 363LF0000X | A149860 | IA | Yes |
Addresses
Primary practice location
512 N New St
Kirksville, MO 63501-3167
Mailing address
512 N New St
Kirksville, MO 63501-3167
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dalton.baker.1@2245.direct.athenahealth.com |
Other providers in Kirksville, MO
- Kelsey Aurand de Razo
- Kathy Ayers
- Randall R Bacon
- John Dee Bailey
- K. Brayden Howard Bailey
- Kimberly Baker
- Shanna N Baker
- John Bambrick
- Alan Richard Barber
- Arnold S Barber
All providers in Kirksville, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.