Individual provider Active NPI

Stephone Delano Devante Baker

  • Kinesiotherapist
  • Daytona Beach, FL
National Provider Identifier
1295236057
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
KinesiotherapistTaxonomy code 226300000X
Practice address
640 Dr Mary McLeod Bethune Blvd
Daytona Beach, FL 32114-3012
Phone
(386) 481-2000
NPI assigned
Feb 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Kinesiotherapist 226300000X FL Primary

Addresses

Primary practice location

640 Dr Mary McLeod Bethune Blvd
Daytona Beach, FL 32114-3012

Mailing address

7216 White Trillium Cir
Orlando, FL 32818-1275
Phone (407) 702-3055

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519603200000",
    "number": "1295236057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7216 WHITE TRILLIUM CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328181275",
            "telephone_number": "407-702-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 DR MARY MCLEOD BETHUNE BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321143012",
            "telephone_number": "386-481-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "STEPHONE",
        "middle_name": "DELANO DEVANTE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.

Verify at the official NPI Registry.