Jody Milford Baham, FNP-BC
Nurse Practitioner, Family in Pooler, GA. Individual provider (NPI-1).
NPI number1699545822
StatusActive
Last updated in NPPESOct 9, 2025
Details
- NPI
- 1699545822
- Entity type
- Individual (NPI-1)
- Name
- Jody Milford Baham
- Credential
- FNP-BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 8, 2024
- Certification date
- Oct 9, 2025
- Last updated
- Oct 9, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B No · DME Yes · Home health No · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | RN287159 | GA | Yes |
| 207QB0002X | Family Medicine, Bariatric Medicine | RN287159 | GA | |
| 207QA0401X | Family Medicine, Addiction Medicine | RN287159 | GA | |
| 261QP3300X | Clinic/Center, Pain | RN287159 | GA |
Practice location
138 Canal St Ste 201Pooler, GA 31322-4047
Phone 912-348-3383 · Fax 912-348-2669
Mailing address
413 Gravel WayBloomingdale, GA 31302-8120
Phone 706-599-7174
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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