Active NPI
Lucas Baker
- Physical Therapist
- Waynesboro, TN
National Provider Identifier
1356115653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15188
- Practice address
- 529 South Main St
Waynesboro, TN 38485 - Phone
- (931) 722-2778
- NPI assigned
- Nov 8, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15188 | TN | Primary |
Addresses
Primary practice location
529 South Main St
Waynesboro, TN 38485
Mailing address
PO Box 450
Waynesboro, TN 38485-0450
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 |
|---|---|---|---|
| 15188 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prestige Physical Therapy | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Columbia, TN
- NPI 1053566463
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699401600000",
"number": "1356115653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 450",
"city": "WAYNESBORO",
"state": "TN",
"postal_code": "384850450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "529 SOUTH MAIN ST",
"city": "WAYNESBORO",
"state": "TN",
"postal_code": "38485",
"telephone_number": "931-722-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "LUCAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-11-08",
"last_updated": "2023-11-08",
"certification_date": "2023-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "15188",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waynesboro, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.