Individual provider Active NPI

Andrea Michelle Baker, P.T., ATC, COF

  • Physical Therapist
  • Spokane, WA
National Provider Identifier
1104885664
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT00006501 Issued in WA
Practice address
511 S Pine Street
Suite a
Spokane, WA 99202-1347
Phone
(509) 325-9144
Fax
(509) 325-0422
NPI assigned
Mar 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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 PT00006501 WA Primary

Addresses

Primary practice location

511 S Pine Street
Suite a
Spokane, WA 99202-1347

Mailing address

PO Box 9879
Spokane, WA 99209-9879
Phone (509) 325-9144

Other identifiers 1

IdentifierTypeStateIssuer
130968OtherWALABOR & INDUSTRIES

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050908000578 WA Practitioner - Physical Therapist in Private Practice 1254363419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Bracing, IncGroup PAC ID 1153492533, 3 clinicians

Practice addresses (Care Compare)

405 E Pacific Ave
Spokane, WA 99202-1434
Phone (509) 325-9144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00006501WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Bracing, Inc CurrentSince Sep 1, 1996 Accepting new patients
Apex Physical Therapy PLLC Physical Therapist PastSince Mar 1, 1999 Accepting new patients

Locations

405 E Pacific Ave
Spokane, WA 99202
Phone (509) 325-9144

511 S Pine St
Ste A
Spokane, WA 99202
Phone (509) 325-9144

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1104885664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9879",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992099879",
            "telephone_number": "509-325-9144",
            "fax_number": "509-325-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 S PINE STREET",
            "address_2": "SUITE A",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021347",
            "telephone_number": "509-325-9144",
            "fax_number": "509-325-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "ANDREA",
        "middle_name": "MICHELLE",
        "credential": "P.T., ATC, COF",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-22",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT00006501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "130968",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.