Theresa E Baker, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6172 Issued in FL

Practice address

501 Centre St
Fernandina Beach, FL 32034-3936

Phone

(904) 321-0121

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-14bfd35d-d818-4696-813b-340339e464ef
• devoted network organization-25ba88d3-d0a6-4213-84f1-eef6f2b59f68
• FL HMO D-SNP
• AL HMO D-SNP
• AL HMO
• FL HMO
• devoted network organization-0f7f8d4f-1035-4992-8c02-dc86d12e700e
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3
• FL HMO C-SNP
• devoted network organization-d5084670-562f-408b-b100-22a1a4ef4d82

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003926288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 CENTRE ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343936",
            "telephone_number": "904-321-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CENTRE ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343936",
            "telephone_number": "904-321-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "THERESA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "6172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BXBS - FL",
            "identifier": "75324",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Authentic Self Counseling of Jacksonville, LLC
• Maelee Corinna Averett
• Zeeshan Sarwar Aziz, M.D.
• Jessica S Bahorski, ARNP, MSN
• Jolaunda Bailey
• Sarah McAllister Baldwin, MA CCC-SLP
• Baptist Agewell Physicians Inc
• Baptist Cardiology, Inc. (Baptist Heart Specialists)
• Baptist ENT Specialists Inc
• Baptist Medical Center of Nassau Inc (Baptist Medical Center Nassau)

• Clinical Psychologist in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• Medicare Care Compare (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.