MEDICARE: ALYSSA RENEE BAKER PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	P24530	NC

General Provider Information

NPI Number	:	1508376153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA RENEE BAKER PT

Provider Business Mailing Address
First Line	:	7904 MARINERS POINTE CIR
Second Line	:
City	:	DENVER
State	:	NC
Zip	:	28037-8091
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7482 WATERSIDE CROSSING BLVD
Second Line	:
City	:	DENVER
State	:	NC
Zip	:	28037-3005
Country	:	US
Telephone Number	:	704-827-0598
Fax Number	:	704-827-5267

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2017
Last Update Date	:	11/25/2025

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