Active NPI
Lucas Baker
- Athletic Trainer
- Morgantown, WV
National Provider Identifier
1124587076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2000028601
- Practice address
- 943 Maple Dr
Morgantown, WV 26505-2812 - Phone
- (304) 599-2515
- NPI assigned
- Mar 19, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2000028601 | WV | Primary |
Addresses
Primary practice location
943 Maple Dr
Morgantown, WV 26505-2812
Mailing address
5466 Iradell Rd
Ithaca, NY 14850-9257
Phone (607) 387-5893
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2000028601 | WV | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552953600000",
"number": "1124587076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5466 IRADELL RD",
"city": "ITHACA",
"state": "NY",
"postal_code": "148509257",
"telephone_number": "607-387-5893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "943 MAPLE DR",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265052812",
"telephone_number": "304-599-2515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "LUCAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-19",
"last_updated": "2019-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WV",
"license": "2000028601",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.