Individual provider Active NPI

Tesha Lee Baker, ARNP

  • Family Nurse Practitioner
  • Avon Park, FL
National Provider Identifier
1124309588
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9180828 Issued in FL
Practice address
1006 W Pleasant St
Avon Park, FL 33825-2966
Phone
(863) 453-3121
Fax
(863) 452-2823
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9180828 FL Primary

Addresses

Primary practice location

1006 W Pleasant St
Avon Park, FL 33825-2966

Mailing address

1006 W Pleasant St
Avon Park, FL 33825-2966
Phone (863) 453-3121

Other identifiers 1

IdentifierTypeStateIssuer
008577600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130610000187 FL Practitioner - Nurse Practitioner 1254570955 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9180828FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System-Sunbelt Inc CurrentSince Apr 1, 2013 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Aug 1, 2014 Accepting new patients
Adventist Health System-Sunbelt Inc CurrentSince Apr 1, 2013 Accepting new patients
Adventist Health System-Sunbelt Inc Past Accepting new patients

Locations

1006 W Pleasant St
Avon Park, FL 33825
Phone (863) 453-3121

1210 US Highway 27 N
Lake Placid, FL 33852
Phone (863) 465-3777

4200 Sun N Lake Blvd
Sebring, FL 33872
Phone (863) 314-4406

4421 Sun N Lake Blvd
Ste C
Sebring, FL 33872
Phone (863) 382-9600

515 Carlton St
Wauchula, FL 33873
Phone (863) 773-6606

522 Carlton St
Wauchula, FL 33873
Phone (863) 773-0975

Organizations & group practices 4

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": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382486400000",
    "number": "1124309588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 W PLEASANT ST",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338252966",
            "telephone_number": "863-453-3121",
            "fax_number": "863-452-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 W PLEASANT ST",
            "city": "AVON PARK",
            "state": "FL",
            "postal_code": "338252966",
            "telephone_number": "863-453-3121",
            "fax_number": "863-452-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "TESHA",
        "middle_name": "LEE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2013-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9180828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008577600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon Park, FL

Sources for this page

Verify at the official NPI Registry.