Jody Milford Baham, FNP-BC

Individual provider Active NPI Family Nurse Practitioner · Pooler, GA

NPI 1699545822 · NPPES record last updated Oct 9, 2025

Key facts

NPI
1699545822
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
RN287159 (GA)
Practice address
138 Canal St Ste 201
Pooler, GA 31322-4047
Phone
(912) 348-3383
Fax
(912) 348-2669
NPI assigned
Jan 8, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
RN287159GAMDAddiction Medicine (Family Medicine) Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN287159 GA Yes
Obesity Medicine (Family Medicine) Physician 207QB0002X RN287159 GA
Addiction Medicine (Family Medicine) Physician 207QA0401X RN287159 GA
Pain Clinic/Center 261QP3300X RN287159 GA

Addresses

Primary practice location

138 Canal St Ste 201
Pooler, GA 31322-4047

Mailing address

413 Gravel Way
Bloomingdale, GA 31302-8120
Phone (706) 599-7174

Other providers in Pooler, GA

All providers in Pooler, GA · Family Nurse Practitioner in Georgia

Sources for this page

Verify at the official NPI Registry.