Denton Healthcare PLLC – General Practice Physician

Key facts

NPI: 1891959094
Entity type: Organization (NPI type 2)
Primary specialty: General Practice Physician 208D00000X
Legal business name: DENTON HEALTHCARE PLLC
Practice address: 18539 S NC Highway 109
Denton, NC 27239-7713
Phone: (336) 859-5001
Fax: (336) 859-1952
NPI assigned: Jul 16, 2008
Organization subpart: No

Authorized official

Name: Dr. Clifton Ayres Baker, M.D.
Title: Co-Owner
Phone: (336) 859-5001

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Clifton A Baker, MD General Practice Physician · Denton, NC · NPI 1053370098

Medicare reassignment NPD FAMILY MEDICINE · NC
Helen Blackburn Primary Care Nurse Practitioner · Denton, NC · NPI 1932215563

Medicare reassignment NPD NC
J Ruth Smith, DNP, FNP-BC, RN Primary Care Nurse Practitioner · Denton, NC · NPI 1467178830

Medicare reassignment NPD NC

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
34D1086998	Denton Healthcare 18539 S NC Hwy 109, Denton, NC 27239	Provider-performed microscopy	Jul 23, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NC

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20081009000792	NC	Part B Supplier - Clinic/Group Practice	0941378475	Receives reassigned benefits from 3 practitioners Practice locations: Denton, NC

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Physician Group: 193400000X SINGLE SPECIALTY GROUP	208D00000X			Yes

Addresses

Primary practice location

18539 S NC Highway 109
Denton, NC 27239-7713

Mailing address

18539 S NC Highway 109
Denton, NC 27239-7713
Phone (336) 859-5001

Other providers in Denton, NC

All providers in Denton, NC · General Practice Physician in North Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.