Individual provider Active NPI

Cassidy Rae Baker, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Parker, CO
National Provider Identifier
1336691302
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6133 Issued in SC
Practice address
11479 Pine Dr Ste 1
Parker, CO 80134-7308
Phone
(303) 919-6799
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6133 SC Primary

Addresses

Primary practice location

11479 Pine Dr Ste 1
Parker, CO 80134-7308

Mailing address

11479 Pine Dr Ste 1
Parker, CO 80134-7308
Phone (303) 919-6799

Other identifiers 1

IdentifierTypeStateIssuer
067536MedicaidCO

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6133SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Haaksma Speech Pathology Inc Speech-Language Pathologist PastSince Jul 24, 2022 Accepting new patients
Haaksma Speech Pathology, LLC Speech-Language Pathologist PastSince Jul 24, 2022 Accepting new patients

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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336691302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11479 PINE DR STE 1",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347308",
            "telephone_number": "303-919-6799",
            "fax_number": "303-374-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11479 PINE DR STE 1",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801347308",
            "telephone_number": "303-919-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "CASSIDY",
        "middle_name": "RAE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "6133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067536",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.