Cynthia Baker

Individual provider Active NPI Licensed Practical Nurse · Greenwood, SC

NPI 1508529413 · NPPES record last updated Oct 18, 2021

Key facts

NPI
1508529413
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
50275 (SC)
Practice address
1547 Parkway
Greenwood, SC 29646-4081
Phone
(864) 229-7120
NPI assigned
Oct 18, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
50275SCMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office Current
since Oct 24, 2021
Accepting new patients

Locations

1547 Parkway
Greenwood, SC 29646
Phone (864) 223-8331

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 50275 SC Yes

Addresses

Primary practice location

1547 Parkway
Greenwood, SC 29646-4081

Mailing address

1547 Parkway
Greenwood, SC 29646-4081

Other identifiers

IdentifierTypeStateIssuer
3335OtherSCMEDICARE
421504MedicaidSC

Other providers in Greenwood, SC

All providers in Greenwood, SC · Licensed Practical Nurse in South Carolina

Sources for this page

Verify at the official NPI Registry.