Individual provider Active NPI

Kelly W Baker, D.C.

  • Chiropractor
  • Chico, CA
National Provider Identifier
1619013398
Registry record updated Sep 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0216250 Issued in CA
Practice address
852 Manzanita CT Ste 150
Chico, CA 95926-2399
Phone
(530) 897-4188
Fax
(530) 345-1835
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0216250 CA Primary

Addresses

Primary practice location

852 Manzanita CT Ste 150
Chico, CA 95926-2399

Mailing address

852 Manzanita CT Ste 150
Chico, CA 95926-2399
Phone (530) 897-4188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050202000336 CA Practitioner - Chiropractic 3072564590 Practice locations: Chico, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

852 Manzanita CT
Suite 150
Chico, CA 95926-2399

Ste
150 852 Manzanita CT
Chico, CA 95926-2399
Phone (530) 897-4188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC0216250CAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1619013398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "852 MANZANITA CT STE 150",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959262399",
            "telephone_number": "530-897-4188",
            "fax_number": "530-345-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "852 MANZANITA CT STE 150",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959262399",
            "telephone_number": "530-897-4188",
            "fax_number": "530-345-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "KELLY",
        "middle_name": "W",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC0216250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.