Jacqueline Baker, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP021672 Issued in PA

Practice address

4700 Wissahickon Ave Ste 110
Philadelphia, PA 19144-4252

Phone

(267) 597-3600

NPI assigned

Mar 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

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.

• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1043204811

  PA

  Medicare reassignment NPD
• Resources for Human Development, Inc.

  • Community/Behavioral Health Agency
  • Bryn Mawr, PA
  • NPI 1548395585

  PA

  Medicare reassignment NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1215696497
  NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1356335129
  NPD
• Family Practice & Counseling Services Network, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1689357782
  NPD
• Resources for Human Development, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1922687714
  NPD
• Resources for Human Development, Inc.

  • Federally Qualified Health Center (FQHC)
  • York, PA
  • NPI 1306127634
  NPD (past)

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1811525819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WISSAHICKON AVE STE 118",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444248",
            "telephone_number": "267-597-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WISSAHICKON AVE STE 110",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191444252",
            "telephone_number": "267-597-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6120 Woodland Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191423200",
            "country_code": "US",
            "telephone_number": "215-727-4721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "JACQUELINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-27",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP021672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "credentialing@fpcn.com",
            "affiliation": "N",
            "address_1": "4700 Wissahickon Ave Ste 118",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191444248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dana N Baker, FNP
• David Richard Baker Jr., M.D.
• Delaney Baker, DMD
• Emma Baker
• Flora Henrietta Baker, RD
• Jeffrey L Baker II
• Jessica Ashley Baker, PA-C
• Joshua Fitzgerald Baker, M.D.
• Julianne Baker, MD
• Katherine Baker, MD

• All providers in Philadelphia, PA
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.