WALLACE C BAKER (NPI# 1134140148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134140148 |
| Entity Type | Organization |
| Organization Name | WALLACE C BAKER |
| Other Organization Name | BAKER FAMILY PRACTICE |
| Practice Address |
1880 John Adams Pkwy Idaho Falls ID 83401-4315 |
| Practice Telephone | 2085246633 |
| Practice Fax Number | 2085249952 |
| Mailing Telephone | 2085246633 |
| Mailing Fax Number | 2085249952 |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2010-07-19 |
| Authorized Official Name | DR. WALLACE C. BAKER (DOCTOR) |
| Authorized Official Telephone | 2085246633 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | M6919 | ID | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | IND NPI NUMBER | 1083696967 | 01 |
| ID | BLUE SHILD INDIVIDUAL | 000010001770 | 01 |
| ID | BLUE SHIELD GROUP NUMBER | 000010027582 | 01 |
| ID | BLUECROSS NUMBER | 72132 | 01 |
| ID | RAILROAD MCR GROUP | D1614 | 01 |
| ID | 807937700 | 05 | |
| ID | GRP BLUECROSS NO. | 8K123 | 01 |
| Other Name | Type Code |
|---|---|
| Baker Family Practice | Other Name - Individual/Organization |
| Street Address |
1880 JOHN ADAMS PKWY |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83401-4315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386626463 | Wade K Christensen | Physician Assistant | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2005-11-15 |
| 1457913162 | Jessica Lynne Christensen | Nurse Practitioner | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2019-07-02 |
| 1588948087 | Joshua E Hansen | Physician Assistant | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2011-10-03 |
| 1639370810 | Wallace Bakers Mid-level Group | Physician Assistant | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2007-05-29 |
| 1538121322 | Laura A Tabor | Physician Assistant | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2006-04-05 |
| 1083696967 | Wallace C Baker | Family Medicine | 1880 John Adams Pkwy, Idaho Falls, ID 83401-4315 | 2005-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454796 | Natalie M Theriault | Acupuncturist | 864 S Holmes, Idaho Falls, ID 83401 | 2020-10-09 |
| 1366099293 | Idaho Recovery Center, LLC. | Counselor | 771 South Woodruff Avenue, Idaho Falls, ID 83401 | 2019-08-26 |
| 1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
| 1467924985 | Benchmark Home Health | Registered Nurse | 2098 Gladys Dr., Idaho Falls, ID 83401 | 2018-12-21 |
| 1134625338 | Idaho Falls Hand Therapy Limited Partnership | Clinic/Center | 564 S Woodruff Avenue, Idaho Falls, ID 83401 | 2018-04-05 |
| 1992227367 | Brenda Emery | Rehabilitation Practitioner | 540 3rd Street, Idaho Falls, ID 83401 | 2017-07-07 |
| 1689068454 | Addiction Treatment Centers of Idaho | Community/Behavioral Health | 211 S. Woodruff Avenue, Idaho Falls, ID 83401 | 2015-03-19 |
| 1386986412 | Jennifer Lee Henderson | Psychologist | 111 E. 16th Street, Innovative Health Care Concepts Inc., Idaho Falls, ID 83401 | 2013-03-27 |
| 1487994430 | Sterling Physician Group Pllc | Clinic/Center | 740 S. Woodruff Ave, Idaho Falls, ID 83401 | 2013-02-27 |
| 1952638025 | Allstar Counseling Inc. | Case Management | 550 2nd Street, Suite 269, Idaho Falls, ID 83401 | 2009-11-11 |
| Find all providers in zip 83401 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740663806 | Rindfleisch Family Practice Pllc | Family Medicine | 4954 E Powerhouse Dr, Idaho Falls, ID 83406-5064 | 2015-07-07 |
| 1013204445 | Machen Family Medicine, PC | Family Medicine | 1995 E 17th St Ste A, Idaho Falls, ID 83404-6493 | 2011-07-06 |
| 1942521109 | Luke N/a Haws | Family Medicine | 2985 Cortez Ave Ste 200, Idaho Falls, ID 83404-7554 | 2010-06-22 |
| 1689993271 | David Lyle Hill | Family Medicine | 3242 S Woodruff, Idaho Falls, ID 83404-7531 | 2010-05-23 |
| 1912120544 | James William Brook | Family Medicine | 905 Austin Ave, Idaho Falls, ID 83404 | 2007-04-11 |
| 1437294345 | Oliver Daniel Smith | Family Medicine | 3669 Ellendale Circle, Idaho Falls, ID 83406 | 2007-02-20 |
| 1023151156 | Physician Skin Care | Family Medicine | 730 S Woodruff Ave, Idaho Falls, ID 83401-5285 | 2007-02-15 |
| 1598837031 | Anne L Broadway | Family Medicine | 2730 Channing Way, Idaho Falls, ID 83404-5049 | 2006-11-13 |
| 1235217506 | Reed Ivol Ward | Family Medicine | 3425 Potomac Way, Idaho Falls, ID 83404-4970 | 2006-11-02 |
| 1770688426 | Tony Craig Roisum | Family Medicine | 3360 Washington Pkwy, Suite 1, Idaho Falls, ID 83404-8332 | 2006-09-14 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83401 |
Please comment or provide details below to improve the information on WALLACE C BAKER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.