Individual provider Active NPI

Shawna Baker, MD

  • Family Medicine Physician
  • Dickinson, ND
National Provider Identifier
1679524896
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
14756 Issued in ND
Practice address
2500 Fairway St
Dickinson, ND 58601-2639
Phone
(701) 456-4000
Fax
(701) 456-4800
NPI assigned
May 12, 2006
Last updated
May 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8002 MT
Family Medicine Physician 207Q00000X 14756 ND Primary

Addresses

Primary practice location

2500 Fairway St
Dickinson, ND 58601-2639

Mailing address

2500 Fairway St
Dickinson, ND 58601-2639
Phone (701) 456-4000

Other identifiers 1

IdentifierTypeStateIssuer
1471958MedicaidND

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170912000040 ND Practitioner - Family Practice 6901091438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Joseph's Hospital and Health CenterGroup PAC ID 0547177560, shared by 3 NPIs, 157 clinicians
Omaha Therapy IncGroup PAC ID 1557270915, 68 clinicians

Practice addresses (Care Compare)

2500 Fairway St
Dickinson, ND 58601-2639
Phone (701) 456-4000

683 State Ave
Dickinson, ND 58601-4660
Phone (701) 483-9400

95 NW 2ND St
Beach, ND 58621
Phone (701) 872-3777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14756NDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Hospital of Anaconda Family Medicine Current Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Sep 1, 2017 Accepting new patients
St Joseph's Hospital and Health Center Current Accepting new patients
St. Joseph's Hospital and Health Center CurrentSince Sep 1, 2017 Accepting new patients
St Josephs Hospital and Health Center Past Accepting new patients
Coal Country Community Health Center Past Accepting new patients

Locations

7360 Solutions Ctr
Chicago, IL 60677
Phone (701) 237-8033

305 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-8571

401 W Pennsylvania Ave
Anaconda, MT 59711
Phone (406) 563-5261

2500 Fairway St
Dickinson, ND 58601
Phone (701) 456-4000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1679524896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 FAIRWAY ST",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586012639",
            "telephone_number": "701-456-4000",
            "fax_number": "701-456-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 FAIRWAY ST",
            "city": "DICKINSON",
            "state": "ND",
            "postal_code": "586012639",
            "telephone_number": "701-456-4000",
            "fax_number": "701-456-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "SHAWNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "8002",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "14756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1471958",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dickinson, ND

Sources for this page

Verify at the official NPI Registry.