Individual provider Active NPI

Lynette N Baker, NP

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1700993011
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
559025 Issued in TX
Practice address
6100 Jacksboro Hwy
Fort Worth, TX 76135-3703
Phone
(817) 237-4594
Fax
(817) 237-3008
NPI assigned
Aug 23, 2006
Last updated
Nov 17, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11607 TN
Family Nurse Practitioner 363LF0000X 559025 TX Primary

Addresses

Primary practice location

6100 Jacksboro Hwy
Fort Worth, TX 76135-3703

Mailing address

6100 Jacksboro Hwy
Fort Worth, TX 76135-3703
Phone (817) 237-4594

Other identifiers 3

IdentifierTypeStateIssuer
204693002MedicaidTX
204693001MedicaidTX
3641817MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080602000723 TX Practitioner - Nurse Practitioner 2961421763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Doctor on Demand Professionals P CGroup PAC ID 9436464567, 113 clinicians

Practice addresses (Care Compare)

211 E 7TH St
Suite 620
Austin, TX 78701-3218
Phone (800) 997-6196

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11607TNMDPharmacist
559025TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Doctor on Demand Professionals P C CurrentSince Oct 1, 2023 Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

275 Battery St
Ste 650
San Francisco, CA 94111
Phone 4155043838104

211 E 7th St
Ste 620
Austin, TX 78701
Phone (415) 742-8411

Interoperability endpoints

  • Direct secure messaging: lynette.baker.1@30520.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1700993011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 JACKSBORO HWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761353703",
            "telephone_number": "817-237-4594",
            "fax_number": "817-237-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 JACKSBORO HWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761353703",
            "telephone_number": "817-237-4594",
            "fax_number": "817-237-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "LYNETTE",
        "middle_name": "N",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "11607",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "559025",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204693002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204693001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3641817",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.