Active NPI
Amanda Lynn Baitz, MOT, OTR
- Occupational Therapist
- Lafayette, IN
National Provider Identifier
1295040814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 99043299A
- Practice address
- 35 Executive Dr Ste 5
Lafayette, IN 47905-4881 - Phone
- (765) 446-8300
- Fax
- (765) 446-8301
- NPI assigned
- Aug 9, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 99043299A | IN | Primary |
Addresses
Primary practice location
35 Executive Dr Ste 5
Lafayette, IN 47905-4881
Mailing address
1104 E Grace St
Rensselaer, IN 47978-3211
Phone (219) 866-5141
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 |
|---|---|---|---|
| 99043299A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522886400000",
"number": "1295040814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1104 E GRACE ST",
"city": "RENSSELAER",
"state": "IN",
"postal_code": "479783211",
"telephone_number": "219-866-5141",
"fax_number": "219-866-3234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 EXECUTIVE DR STE 5",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479054881",
"telephone_number": "765-446-8300",
"fax_number": "765-446-8301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAITZ",
"first_name": "AMANDA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "MOT, OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-09",
"last_updated": "2018-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "99043299A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.