Individual provider Active NPI

Sally Jo Baker, CRNA

  • Certified Registered Nurse Anesthetist
  • Huntington, WV
National Provider Identifier
1679645709
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
43588 Issued in WV
Practice address
2900 First Avenue
Huntington, WV 25702-1241
Phone
(304) 526-1031
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 43588 WV Primary
Certified Registered Nurse Anesthetist 367500000X 04994 OH

Addresses

Primary practice location

2900 First Avenue
Huntington, WV 25702-1241

Mailing address

PO Box 515
Barboursville, WV 25504-0515
Phone (304) 736-6126

Other identifiers 3

IdentifierTypeStateIssuer
55-0696369-00OtherWVWV WORKERS COMP #
001710226OtherWVW.V. BLUE CROSS PROVIDER
0068000000MedicaidWV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040608000764 WV Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618950023 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of West Virginia PLLCGroup PAC ID 2668750241, 124 clinicians

Practice addresses (Care Compare)

1340 Hal Greer Blvd
Huntington, WV 25701-3804
Phone (304) 526-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
04994OHMDCertified Registered Nurse Anesthetist
43588WVMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Cabell Huntington Hospital Inc Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2007 Accepting new patients
Oasis Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2018 Accepting new patients
Cabell Huntington Hospital Inc CurrentSince Feb 1, 2007 Accepting new patients
Northstar Anesthesia of West Virginia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Sep 12, 2016 Accepting new patients
Charleston Surgical Hospital Healthcare Group, PLLC Past Accepting new patients
Cardiac Anesthesia Plus, Inc. PastSince Jun 1, 2004 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

405 S 3rd St
Ironton, OH 45638
Phone (304) 417-1255

2335 Chesterfield Ave
Ste 400
Charleston, WV 25304
Phone (304) 417-1255

1340 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 399-2960

1201 Hal Greer Blvd
Huntington, WV 25701
Phone (304) 523-1885

2900 1st Ave
Huntington, WV 25702
Phone (304) 526-1111

2900 1st Ave
Ste 6019
Huntington, WV 25702
Phone (304) 399-0137

2900 1st Ave
Rm 601
Huntington, WV 25702
Phone (304) 399-0137

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1679645709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 515",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255040515",
            "telephone_number": "304-736-6126",
            "fax_number": "304-736-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FIRST AVENUE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257021241",
            "telephone_number": "304-526-1031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "SALLY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-14",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WV",
            "license": "43588",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "04994",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV WORKERS COMP #",
            "identifier": "55-0696369-00",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "W.V. BLUE CROSS PROVIDER",
            "identifier": "001710226",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0068000000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.