Tyjashanikqa Baker
Individual provider Active NPI Family Nurse Practitioner · Guyton, GA
NPI 1356035992 · NPPES record last updated Jun 6, 2023
Key facts
- NPI
- 1356035992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN255049 (GA)
- Practice address
- 113 Blue Grass Cir
Guyton, GA 31312-5537 - Phone
- (912) 547-2315
- NPI assigned
- Jun 6, 2023
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Curtis V. Cooper Primary Health Care, Inc.
Practice addresses (Care Compare)
106 E Broad St
Savannah, GA 31401-2917
Phone (912) 527-1000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- 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 |
|---|---|---|---|---|
| I20240327003368 | GA | Practitioner - Nurse Practitioner | 5799122693 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Curtis V. Cooper Primary Health Care, Inc | Current | Accepting new patients | |
| Curtis V. Cooper Primary Health Care Inc. | Current |
Accepting new patients | |
| Curtis V. Cooper Primary Health Care, Inc | Current |
Accepting new patients | |
| Curtis V. Cooper Primary Health Care Inc. | Current | Accepting new patients | |
| Signify Health Medical Associates, PLLC | 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) 891-9833
304 Stephenson Ave
Savannah, GA 31405
106 E Broad St
Savannah, GA 31401
Phone (912) 527-1100
2 Roberts St
Savannah, GA 31408
Phone (912) 527-1100
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN255049 | GA | Yes |
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
Other providers in Guyton, GA
- Tanita L Akinyokunbo
- Bailey Elliott Alford
- Destiny Cierra Andrews
- Jennifer Bachinger
- Brittany Barnes
- Sheridan M Bell
- Blessings Beyond Me Case Management, LLC
- Katrina Blige
- Blue Iris Therapeutic Services
All providers in Guyton, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2023. 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.