Individual provider Active NPI

Kenneth W Baker, FNP

  • Adult Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1831297266
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
577002 Issued in TX
Practice address
3917 W Camp Wisdom Rd
Dallas, TX 75237-2468
Phone
(972) 709-7259
Fax
(972) 709-7252
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 577002 TX Primary

Addresses

Primary practice location

3917 W Camp Wisdom Rd
Dallas, TX 75237-2468

Mailing address

2905 Davis Dr
Midlothian, TX 76065-9162
Phone (817) 991-9730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
577002TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
American Visiting Doctors LLC Past Accepting new patients
Michael Lynn Littlejohn Past Accepting new patients
Medistat Group Associates, Inc. Adult Health Past Accepting new patients
Community Housecall Systems Inc Past Accepting new patients
Bay Outpatient Rehab Clinic LLC Adult Health Past Accepting new patients
Rodney T Franklin, MD, PA Past Accepting new patients
Healthtexas Provider Network Past Accepting new patients

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1831297266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 DAVIS DR",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760659162",
            "telephone_number": "817-991-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 W CAMP WISDOM RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752372468",
            "telephone_number": "972-709-7259",
            "fax_number": "972-709-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "KENNETH",
        "middle_name": "W",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "577002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.