Active NPI
Maris Baylor
- Clinical Social Worker
- Bloomington, IL
National Provider Identifier
1902415151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- C014856
- Practice address
- 207 E Hamilton Rd
Bloomington, IL 61704-7527 - Phone
- (309) 827-4090
- NPI assigned
- Jul 23, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C014856 | NC | Primary |
Addresses
Primary practice location
207 E Hamilton Rd
Bloomington, IL 61704-7527
Mailing address
4920 Unaka Ave
Charlotte, NC 28205-7334
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250529003669 | NC | Order and Referring Only - Clinical Social Worker | 2961911292 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1657065600000",
"number": "1902415151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4920 UNAKA AVE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282057334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 E HAMILTON RD",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617047527",
"telephone_number": "309-827-4090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAYLOR",
"first_name": "MARIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-23",
"last_updated": "2022-07-06",
"certification_date": "2022-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "C014856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomington, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.