Derralyn M Harris Baker, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

052739 Issued in GA

Practice address

1315 Delauney Ave
Suite201
Columbus, GA 31901-2367

Phone

(706) 322-9599

Fax

(706) 322-8332

NPI assigned

Jun 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Valley Healthcare System

  • Federally Qualified Health Center (FQHC)
  • Columbus, GA
  • NPI 1851924377
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327881600000",
    "number": "1851334767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 DELAUNAY AVENUE",
            "address_2": "SUITE 201",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319012204",
            "telephone_number": "706-322-9599",
            "fax_number": "706-322-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 DELAUNEY AVE",
            "address_2": "SUITE201",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319012367",
            "telephone_number": "706-322-9599",
            "fax_number": "706-322-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS BAKER",
        "first_name": "DERRALYN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "052739",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "00026689",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311838518A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311838518C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311838518B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "632200004",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Louis Harrell Jr., PHARM.D.
• Jordan P Harrell, MD
• Takeshia Harrell, RBT
• Lana Harrelson, MHP
• Rebecca Harrington, PT
• Octavia Harris-Davis
• Ashlin Harris-O'Neil, CCC-SLP
• Aisha Harris
• Alexis Deanna Harris
• Alexus Nicole Harris

• Family Medicine Physician in Columbus, GA
• Providers in Columbus, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; 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.