Krystal D Baker, HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

3213 Issued in IL

Practice address

301 S Webster St
Taylorville, IL 62568-2150

Phone

(217) 824-0411

NPI assigned

Aug 11, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Krystal D Longden Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Specialized Hearing Solutions LLC

  • Hearing Instrument Specialist
  • Taylorville, IL
  • NPI 1396367173
  NPD Authorized official

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1548636715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 N 1350 EAST RD",
            "city": "OWANECO",
            "state": "IL",
            "postal_code": "625555517",
            "telephone_number": "217-820-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S WEBSTER ST",
            "city": "TAYLORVILLE",
            "state": "IL",
            "postal_code": "625682150",
            "telephone_number": "217-824-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "KRYSTAL",
        "middle_name": "D",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043117357",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "3213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTAL",
            "last_name": "LONGDEN",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Abundant Life Medical Clinic, LLC
• Kristina Grace Allen, M.A., CF-SLP
• Alicia Altheimer, MD
• Joseph Barron, DC
• Linda L. Berck, MS, CCC-SLP/L
• Donald Dennis Bettis, BC-HIS
• Scott M Bilyeu, M.D.
• Lori A Bland, NP-C

• All providers in Taylorville, IL
• Hearing Instrument Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; 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.