Active NPI
Chester Riley Baker, NP RN CS
- Family Nurse Practitioner
- Cornelia, GA
National Provider Identifier
1396735155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 146348
- Practice address
- 130 Magnolia LN
Cornelia, GA 30531-2241 - Phone
- (706) 776-3070
- Fax
- (706) 776-3788
- NPI assigned
- Oct 24, 2005
- Last updated
- Sep 9, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 146348 | GA | Primary |
Addresses
Primary practice location
130 Magnolia LN
Cornelia, GA 30531-2241
Mailing address
130 B Magnolia Lane
Cornelia, GA 30531
Phone (706) 776-3070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 035805515A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Jun 20, 2016 through Jun 20, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146348 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Practice of Habersham PC | Past | Accepting new patients | |
| Tims Pharmacy Inc | Past | Accepting new patients | |
| Tims Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Primary Care Clinic/Center
- Demorest, GA
- NPI 1124154794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252454400000",
"number": "1396735155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 B MAGNOLIA LANE",
"city": "CORNELIA",
"state": "GA",
"postal_code": "30531",
"telephone_number": "706-776-3070",
"fax_number": "706-776-3788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 MAGNOLIA LN",
"city": "CORNELIA",
"state": "GA",
"postal_code": "305312241",
"telephone_number": "706-776-3070",
"fax_number": "706-776-3788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "CHESTER",
"middle_name": "RILEY",
"name_prefix": "Mr.",
"credential": "NP RN CS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2009-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "146348",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "035805515A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cornelia, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.