Individual provider Active NPI

Staralee Baird, LMSW

  • Social Worker
  • Chubbuck, ID
National Provider Identifier
1013344696
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LMSW-30706 Issued in ID
Practice address
210 W Burnside Ave
Chubbuck, ID 83202-4916
Phone
(208) 238-9000
Fax
(208) 238-9002
NPI assigned
Sep 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-30706 ID Primary

Addresses

Primary practice location

210 W Burnside Ave
Chubbuck, ID 83202-4916

Mailing address

210 W Burnside Ave
Chubbuck, ID 83202-4916
Phone (208) 238-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20171206003136 ID Practitioner - Clinical Social Worker 4082971478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mental Health SpecialistsGroup PAC ID 1658665427, 11 clinicians

Practice addresses (Care Compare)

210 W Burnside Ave
Suite a
Pocatello, ID 83202-4916
Phone (208) 238-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-30706IDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialists Clinical CurrentSince Oct 11, 2017 Accepting new patients
Mental Health Specialists Social Worker Past Accepting new patients

Locations

210 W Burnside Ave
Ste A
Pocatello, ID 83202
Phone (208) 238-9000

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1013344696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W BURNSIDE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832024916",
            "telephone_number": "208-238-9000",
            "fax_number": "208-238-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W BURNSIDE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832024916",
            "telephone_number": "208-238-9000",
            "fax_number": "208-238-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIRD",
        "first_name": "STARALEE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-30706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chubbuck, ID

Sources for this page

Verify at the official NPI Registry.