Active NPI
Stacey Baskerville
- Intermediate Emergency Medical Technician
- Sweeny, TX
National Provider Identifier
1417099565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intermediate Emergency Medical Technician
- License
- 139905
- Practice address
- 300 Silverleaf Rd Apt 1201
Sweeny, TX 77480-1839 - Phone
- (979) 482-4637
- NPI assigned
- Feb 13, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Intermediate Emergency Medical Technician | 146M00000X | 139905 | TX | Primary |
Addresses
Primary practice location
300 Silverleaf Rd Apt 1201
Sweeny, TX 77480-1839
Mailing address
300 Silverleaf Rd Apt 1201
Sweeny, TX 77480-1839
Phone (979) 482-4637
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1824609 | Medicaid | TX |
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 |
|---|---|---|---|
| 139905 | TX | MD | Intermediate Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417099565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 SILVERLEAF RD APT 1201",
"city": "SWEENY",
"state": "TX",
"postal_code": "774801839",
"telephone_number": "979-482-4637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 SILVERLEAF RD APT 1201",
"city": "SWEENY",
"state": "TX",
"postal_code": "774801839",
"telephone_number": "979-482-4637"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BASKERVILLE",
"first_name": "STACEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "146M00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Intermediate",
"state": "TX",
"license": "139905",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1824609",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sweeny, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.