Individual provider Active NPI

Ryan Baker, NP

  • Gerontology Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1821480047
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
19325 Issued in SC
Practice address
6 Richland Medical Park Dr Ste 2100
Columbia, SC 29203
Phone
(803) 434-2762
NPI assigned
Feb 25, 2015
Last updated
Mar 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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 19325 SC
Gerontology Nurse Practitioner 363LG0600X 19325 SC Primary

Addresses

Primary practice location

6 Richland Medical Park Dr Ste 2100
Columbia, SC 29203

Mailing address

112 Saluda Ridge CT
Ste 200
West Columbia, SC 29169-3461
Phone (803) 296-7320

Other practice location 1

8 Richland Medical Park Dr
Suite 100
Columbia, SC 29203-8005
Phone (803) 434-3800

Other identifiers 1

IdentifierTypeStateIssuer
NP3818MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
19325SCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Intramed Plus Infusion & Medical Center, LLC Nurse Practitioner CurrentSince Mar 1, 2020 Accepting new patients

Locations

112 Saluda Ridge Ct
Ste 200
West Columbia, SC 29169
Phone (803) 358-0158

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": "1424822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1821480047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 SALUDA RIDGE CT",
            "address_2": "STE 200",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693461",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 RICHLAND MEDICAL PARK DR STE 2100",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "29203",
            "telephone_number": "803-434-2762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 Richland Medical Park Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "SC",
            "postal_code": "292038005",
            "country_code": "US",
            "telephone_number": "803-434-3800",
            "fax_number": "803-744-2759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-25",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "19325",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "19325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3818",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.