Brenda Angelique Baldwin, RN

Primary specialty

Community Health Registered NurseTaxonomy code 163WC1500X

License

91777 Issued in SC

Practice address

158 Beverly Cir
Liberty, SC 29657-8933

Phone

(864) 915-8191

NPI assigned

May 14, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Brenda Angelique Callaham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1861014698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 BEVERLY CIR",
            "city": "LIBERTY",
            "state": "SC",
            "postal_code": "296578933",
            "telephone_number": "864-915-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "158 BEVERLY CIR",
            "city": "LIBERTY",
            "state": "SC",
            "postal_code": "296578933",
            "telephone_number": "864-915-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "BRENDA",
        "middle_name": "ANGELIQUE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "SC",
            "license": "91777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "CALLAHAM",
            "middle_name": "ANGELIQUE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• All providers in Liberty, SC
• Community Health Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.