Individual provider Active NPI

Cindy Lynne Baca, OTR

  • Occupational Therapist
  • Fowler, CO
National Provider Identifier
1053684845
Registry record updated Feb 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1424 Issued in CO
Practice address
66312 US Highway 50
Fowler, CO 81039-9606
Phone
(719) 568-0040
NPI assigned
Feb 9, 2012
Last updated
Feb 9, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1424 CO Primary

Addresses

Primary practice location

66312 US Highway 50
Fowler, CO 81039-9606

Mailing address

66312 US Highway 50
Fowler, CO 81039-9606
Phone (719) 568-0040

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1424COMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1328745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328745600000",
    "number": "1053684845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66312 US HIGHWAY 50",
            "city": "FOWLER",
            "state": "CO",
            "postal_code": "810399606",
            "telephone_number": "719-568-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66312 US HIGHWAY 50",
            "city": "FOWLER",
            "state": "CO",
            "postal_code": "810399606",
            "telephone_number": "719-568-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACA",
        "first_name": "CINDY",
        "middle_name": "LYNNE",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-09",
        "last_updated": "2012-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "1424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fowler, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2012; 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.