NPIMap

Individual provider Active NPI

Norah Claire Farley Baker, M.D.

  • Family Medicine Physician
  • Maryville, IL
National Provider Identifier
1407144819
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-134056 Issued in IL
Practice address
10 Professional Park Dr.
Maryville, IL 62062
Phone
(618) 288-7244
Fax
(618) 288-1980
NPI assigned
Jul 19, 2011
Last updated
Mar 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-134056 IL Primary

Addresses

Primary practice location

10 Professional Park Dr.
Maryville, IL 62062

Mailing address

6810 State Route 162 Box 215
Maryville, IL 62062-8501
Phone (618) 391-6405

Other identifiers 1

IdentifierTypeStateIssuer
036134056MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140916002480 IL Practitioner - Family Practice 2264672245 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Southern Illinois University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Medical Group IncGroup PAC ID 6608776299, 565 clinicians

Practice addresses (Care Compare)

1000 Eleven S
Suite 4a
Columbia, IL 62236-1077
Phone (618) 206-6120

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-134056ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Family Medicine Current Accepting new patients
SSM Medical Group Inc. CurrentSince May 23, 2022 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Aug 4, 2014 Accepting new patients
SSM Medical Group, Inc. CurrentSince May 23, 2022 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Aug 4, 2014 Accepting new patients
SSM Health Care St. Louis Past Accepting new patients
Malench & Malench MDS Family Medicine PastSince Mar 22, 2020 Accepting new patients
Family Practice Associates, PC Family Medicine PastSince Jan 25, 2016 Accepting new patients

Locations

1000 Eleven S
Ste 4A
Columbia, IL 62236
Phone (618) 206-6120

705 S Grand St
Nashville, IL 62263
Phone (618) 327-2200

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

Interoperability endpoints

  • Direct secure messaging: nbaker423093@direct-ehr-ssmhc.com
  • Direct secure messaging: ncbaker@yourcarecommunity.org

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1407144819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162 BOX 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628501",
            "telephone_number": "618-391-6405",
            "fax_number": "618-288-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PROFESSIONAL PARK DR.",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "62062",
            "telephone_number": "618-288-7244",
            "fax_number": "618-288-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "NORAH",
        "middle_name": "CLAIRE FARLEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-134056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036134056",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.