Individual provider Active NPI

Sara Baker, PT, DPT

  • Physical Therapist
  • Orange Park, FL
National Provider Identifier
1073066643
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT31692 Issued in FL
Practice address
500 Park Ave
Orange Park, FL 32073-3132
Phone
(904) 278-7890
NPI assigned
Jul 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT31692 FL Primary

Addresses

Primary practice location

500 Park Ave
Orange Park, FL 32073-3132

Mailing address

460 Mall Blvd Ste B
Savannah, GA 31406-4891
Phone (912) 644-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211209000789 WA Practitioner - Physical Therapist in Private Practice 1658781968 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT31692FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 24, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 24, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Optim Orthopedics, LLC CurrentSince Feb 1, 2021 Accepting new patients
Optim Orthopedics, LLC CurrentSince Feb 1, 2021 Accepting new patients
Northern Asset Management Inc Physical Therapist CurrentSince Feb 8, 2021 Accepting new patients
Farwest Rehabilitation, Inc PastSince Feb 8, 2021 Accepting new patients
Optim Orthopedics, LLC PastSince Oct 6, 2019 Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients

Locations

2835 Childress Dr
Anderson, CA 96007
Phone (530) 378-0998

247 S Main St
#A
Reidsville, GA 30453
Phone (912) 352-4490

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

16915 Highway 67
#A
Statesboro, GA 30458
Phone (912) 681-2500

2930 Maple St
Everett, WA 98201
Phone (425) 261-1500

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: sbaker3940273@ghc.direct-ci.net

Organizations & group practices 9

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": "1469750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1073066643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 MALL BLVD STE B",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064891",
            "telephone_number": "912-644-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PARK AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320733132",
            "telephone_number": "904-278-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "SARA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-29",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT31692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.