Individual provider Active NPI

Mary Jo D. Baker, APRN

  • Family Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1467969139
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3011965 Issued in KY
Practice address
5796 Nashville Rd
Bowling Green, KY 42101-7546
Phone
(270) 781-6477
Fax
(270) 647-7780
NPI assigned
Jan 4, 2018
Last updated
Jan 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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 3011965 KY Primary

Addresses

Primary practice location

5796 Nashville Rd
Bowling Green, KY 42101-7546

Mailing address

201 Park St
Bowling Green, KY 42101-1759
Phone (270) 781-6477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20180202000863 KY Practitioner - Nurse Practitioner 0345500724 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3011965KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Feb 5, 2018 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Feb 5, 2018 Accepting new patients

Locations

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

5575 Scottsville Rd
Bowling Green, KY 42104
Phone (270) 282-7088

5796 Nashville Rd
Bowling Green, KY 42101
Phone (270) 745-0987

6807 Louisville Rd
Bowling Green, KY 42101
Phone (270) 597-3757

400 N Dixie Hwy
Cave City, KY 42127
Phone (270) 773-2600

Interoperability endpoints

  • Direct secure messaging: maryjobaker@ggc.allscriptsdirect.net

Organizations & group practices 2

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": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1467969139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011759",
            "telephone_number": "270-781-6477",
            "fax_number": "270-647-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5796 NASHVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421017546",
            "telephone_number": "270-781-6477",
            "fax_number": "270-647-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "MARY JO",
        "middle_name": "D.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3011965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.