Individual provider Active NPI

Amanda Mercedes Baker, CNM, WHNP-BC

  • Women's Health Nurse Practitioner
  • Kingman, AZ
National Provider Identifier
1871182246
Registry record updated May 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
247851 Issued in AZ
Practice address
1739 E Beverly Ave Ste 200
Kingman, AZ 86409-3593
Phone
(928) 681-8705
NPI assigned
Jan 11, 2021
Last updated
May 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 247851 AZ
Women's Health Nurse Practitioner 363LW0102X 247851 AZ Primary

Addresses

Primary practice location

1739 E Beverly Ave Ste 200
Kingman, AZ 86409-3593

Mailing address

1739 E Beverly Ave Ste 200
Kingman, AZ 86409-3593
Phone (928) 681-8705

Other practice location 1

2045 S Vineyard Ste 136
Mesa, AZ 85210-6891
Phone (480) 565-5990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20220525000678 AZ Practitioner - Nurse Practitioner 4880071273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kingman Healthcare IncGroup PAC ID 6901791367, 185 clinicians

Practice addresses (Care Compare)

1739 E Beverly Ave
Suite 200
Kingman, AZ 86409-3593
Phone (928) 681-8705

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.85 of 100Reported as group
Quality
84.49
Promoting interoperability
83
Improvement activities
40
Cost
79.17

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
247851AZMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Kingman Healthcare, Inc Current Accepting new patients
Kingman Healthcare, Inc CurrentSince Jul 1, 2022 Accepting new patients
Kingman Healthcare, Inc CurrentSince Jul 1, 2022 Accepting new patients

Locations

1739 E Beverly Ave
Kingman, AZ 86409
Phone (928) 263-4547

1739 E Beverly Ave
Ste 200
Kingman, AZ 86409
Phone (928) 263-4722

3269 N Stockton Hill Rd
Kingman, AZ 86409
Phone (928) 757-0626

Interoperability endpoints

  • Direct secure messaging: baker.amanda@direct.azkrmc.md
  • Direct secure messaging: baker.amanda@st.direct.azkrmc.md

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1610323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1871182246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 E BEVERLY AVE STE 200",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093593",
            "telephone_number": "928-681-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 E BEVERLY AVE STE 200",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864093593",
            "telephone_number": "928-681-8705"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2045 S Vineyard Ste 136",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852106891",
            "country_code": "US",
            "telephone_number": "480-565-5990",
            "fax_number": "623-208-7666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAKER",
        "first_name": "AMANDA",
        "middle_name": "MERCEDES",
        "credential": "CNM, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-11",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "247851",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "247851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingman, AZ

Sources for this page

Verify at the official NPI Registry.