Individual provider Active NPI

Susan Christine Baird, PH.D.

  • Clinical Psychologist
  • Kalamazoo, MI
National Provider Identifier
1497899801
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6301012476 Issued in MI
Practice address
2632 S 11TH St
Kalamazoo, MI 49009-2106
Phone
(269) 873-8002
NPI assigned
Feb 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6301012476 MI Primary

Addresses

Primary practice location

2632 S 11TH St
Kalamazoo, MI 49009-2106

Mailing address

2632 S 11TH St
Kalamazoo, MI 49009-2106

Other identifiers 3

IdentifierTypeStateIssuer
11608898OtherMICAQH PROVIDER ID
6301012476OtherMIPROFESSIONAL LICENSE NUMB
68-0-C9-1310-0OtherMIBCBSM PIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070802000390 MI Practitioner - Clinical Psychologist 0941391197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2632 S 11TH St
Kalamazoo, MI 49009-2106
Phone (269) 873-8002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6301012476MIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Valued Living Psychological Clinical CurrentSince Dec 19, 2021 Accepting new patients
Mid-America Psychological Services, P. C. PastSince Jul 1, 1990 Accepting new patients

Locations

5380 Holiday Ter
Ste 33
Kalamazoo, MI 49009
Phone (269) 207-0272

2632 S 11th St
Kalamazoo, MI 49009
Phone (269) 873-8002

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1497899801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2632 S 11TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2632 S 11TH ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490092106",
            "telephone_number": "269-873-8002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIRD",
        "first_name": "SUSAN",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-18",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11608898",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE NUMB",
            "identifier": "6301012476",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "68-0-C9-1310-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

Verify at the official NPI Registry.