Active NPI
Mark R Baker, DMD
- Periodontics
- Anderson, SC
National Provider Identifier
1508992520
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 2908-0379
- Practice address
- 514 Reed Rd
Anderson, SC 29621-2058 - Phone
- (864) 225-3141
- Fax
- (864) 225-3142
- NPI assigned
- Feb 26, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2908-0379 | SC | Primary |
Addresses
Primary practice location
514 Reed Rd
Anderson, SC 29621-2058
Mailing address
514 Reed Rd
Anderson, SC 29621-2058
Phone (864) 225-3141
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191218000060 | SC | Order and Referring Only - Oral Surgery | 6608200019 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2908-0379 | SC | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anderson Periodontic Associates | Periodontics | Past | Accepting new patients |
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.
-
- Periodontics
- Anderson, SC
- NPI 1588842116
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508992520",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "514 REED RD",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296212058",
"telephone_number": "864-225-3141",
"fax_number": "864-225-3142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "514 REED RD",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296212058",
"telephone_number": "864-225-3141",
"fax_number": "864-225-3142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "MARK",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "SC",
"license": "2908-0379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.