Charlotte Baker, R.D.

Individual provider Active NPI Registered Dietitian · Amory, MS

NPI 1356446231 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1356446231
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
D461 (MS)
Practice address
1105 Earl Frye Blvd
Amory, MS 38821-5500
Phone
(662) 256-6261
Fax
(662) 256-6181
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
D461MSMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Amory Primary Medicine Clinic Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X D461 MS Yes

Addresses

Primary practice location

1105 Earl Frye Blvd
Amory, MS 38821-5500

Mailing address

1105 Earl Frye Blvd
Amory, MS 38821-5500
Phone (662) 256-6261

Other providers in Amory, MS

All providers in Amory, MS · Registered Dietitian in Mississippi

Sources for this page

Verify at the official NPI Registry.