Individual provider Active NPI

Dustin Kyle Baker, COTA/L

  • Occupational Therapy Assistant
  • Birmingham, AL
National Provider Identifier
1043941610
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
5746 Issued in AL
Practice address
622-692 10TH St SW
Birmingham, AL 35211
Phone
(205) 783-3292
NPI assigned
Jun 23, 2022
Sex
Male
Sole proprietor
No

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5746ALMDOccupational Therapy Assistant

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5746 AL Primary

Addresses

NPPES NPI Registry

Primary practice location

622-692 10TH St SW
Birmingham, AL 35211

Mailing address

1306 Elderberry St
Pell City, AL 35128-7345
Phone (205) 516-2842

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 23, 2022.

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1043941610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 ELDERBERRY ST",
            "city": "PELL CITY",
            "state": "AL",
            "postal_code": "351287345",
            "telephone_number": "205-516-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622-692 10TH ST SW",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "35211",
            "telephone_number": "205-783-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "DUSTIN",
        "middle_name": "KYLE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AL",
            "license": "5746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.