Individual provider Active NPI

Tyjashanikqa Baker

  • Family Nurse Practitioner
  • Guyton, GA
National Provider Identifier
1356035992
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN255049 Issued in GA
Practice address
113 Blue Grass Cir
Guyton, GA 31312-5537
Phone
(912) 547-2315
NPI assigned
Jun 6, 2023
Last updated
Jun 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN255049 GA Primary

Addresses

Primary practice location

113 Blue Grass Cir
Guyton, GA 31312-5537

Mailing address

113 Blue Grass Cir
Guyton, GA 31312-5537
Phone (912) 547-2315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240327003368 GA Practitioner - Nurse Practitioner 5799122693 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

106 E Broad St
Savannah, GA 31401-2917
Phone (912) 527-1000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Curtis V. Cooper Primary Health Care Inc. CurrentSince Feb 27, 2024 Accepting new patients
Curtis V. Cooper Primary Health Care, Inc Current Accepting new patients
Curtis V. Cooper Primary Health Care, Inc CurrentSince Feb 27, 2024 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Feb 19, 2024 Accepting new patients
Curtis V. Cooper Primary Health Care Inc. Current Accepting new patients
Curtis V. Cooper Primary Health Care, Inc. Past Accepting new patients
Curtis V. Cooper Primary Health Care, Inc Past Accepting new patients

Locations

2451 Little Neck Rd
Bloomingdale, GA 31302

289 S Culver St
Lawrenceville, GA 30046
Phone (404) 458-0809

106 E Broad St
Savannah, GA 31401
Phone (912) 527-1100

2 Roberts St
Savannah, GA 31408
Phone (912) 527-1100

304 Stephenson Ave
Savannah, GA 31405

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 7

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": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1356035992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 BLUE GRASS CIR",
            "city": "GUYTON",
            "state": "GA",
            "postal_code": "313125537",
            "telephone_number": "912-547-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 BLUE GRASS CIR",
            "city": "GUYTON",
            "state": "GA",
            "postal_code": "313125537",
            "telephone_number": "912-547-2315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "TYJASHANIKQA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN255049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Guyton, GA

Sources for this page

Verify at the official NPI Registry.