Individual provider Active NPI

Chastity Fawn Baken

  • Case Manager/Care Coordinator
  • Tishomingo, OK
National Provider Identifier
1508497173
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
108 W Main St
Tishomingo, OK 73460-1723
Phone
(580) 371-3019
Fax
(580) 371-0138
NPI assigned
Jan 31, 2020
Last updated
Jan 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

108 W Main St
Tishomingo, OK 73460-1723

Mailing address

PO Box 970
Tishomingo, OK 73460-0970
Phone (580) 371-3019

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1508497173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734600970",
            "telephone_number": "580-371-3019",
            "fax_number": "580-371-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W MAIN ST",
            "city": "TISHOMINGO",
            "state": "OK",
            "postal_code": "734601723",
            "telephone_number": "580-371-3019",
            "fax_number": "580-371-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKEN",
        "first_name": "CHASTITY",
        "middle_name": "FAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tishomingo, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.