Individual provider Active NPI

Malachi Baker III, HEALTH CARE PROVIDER

  • Home Health Aide
  • Tampa, FL
National Provider Identifier
1376261503
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
Practice address
1717 East Cayuga St
Same Above
Tampa, FL 33610
Phone
(813) 475-0887
NPI assigned
Aug 15, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health AideGroup: 193400000X SINGLE SPECIALTY GROUP 374U00000X FL Primary

Addresses

Primary practice location

1717 East Cayuga St
Same Above
Tampa, FL 33610

Mailing address

1717 East Cayuga St
Same Above
Tampa, FL 33610-6025
Phone (813) 306-0618

Other identifiers 1

IdentifierTypeStateIssuer
883599704OtherFLHOME HEALTH CARE PROVIDER

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": "1660521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1376261503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 EAST CAYUGA ST",
            "address_2": "SAME ABOVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336106025",
            "telephone_number": "813-306-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 EAST CAYUGA ST",
            "address_2": "SAME ABOVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33610",
            "telephone_number": "813-475-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "MALACHI",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "HEALTH CARE PROVIDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-15",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH CARE PROVIDER",
            "identifier": "883599704",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.