Individual provider Active NPI

Skyler Drew Baker

  • Mental Health Counselor
  • Johnson City, TN
National Provider Identifier
1336919638
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
403 Princeton Rd Ste 2
Johnson City, TN 37601-2040
Phone
(276) 202-5016
NPI assigned
Jan 8, 2024
Last updated
Jun 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5904 TN
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

403 Princeton Rd Ste 2
Johnson City, TN 37601-2040

Mailing address

403 Princeton Rd Ste 2
Johnson City, TN 37601-2040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250210001640 TN Practitioner - Mental Health Counselor 6406383223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tranquil JC, LLCGroup PAC ID 9537587142, 4 clinicians

Practice addresses (Care Compare)

207 E Main St
Suite 2E
Johnson City, TN 37604-5749
Phone (423) 430-9362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tranquil JC, LLC CurrentSince Dec 17, 2024 Accepting new patients

Locations

207 E Main St
Ste 2E
Johnson City, TN 37604
Phone (423) 282-2516

Organizations & group practices 1

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": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1336919638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 PRINCETON RD STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 PRINCETON RD STE 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376012040",
            "telephone_number": "276-202-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "SKYLER",
        "middle_name": "DREW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": "5904",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.