Active NPI
James D Baxendale, PH.D., CTS
- Professional Counselor
- Fuquay Varina, NC
National Provider Identifier
1427162676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 10653
- Practice address
- 64 Sweet Samantha CT
Fuquay Varina, NC 27526-5054 - Phone
- (704) 290-7527
- NPI assigned
- Aug 17, 2006
- Last updated
- Oct 7, 2014
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 068.0099603 | VT | |
| Mental Health Counselor | 101YM0800X | 002890-1 | NY | |
| Professional Counselor | 101YP2500X | 10653 | NC | Primary |
Addresses
Primary practice location
64 Sweet Samantha CT
Fuquay Varina, NC 27526-5054
Mailing address
64 Sweet Samantha CT
Fuquay Varina, NC 27526-5054
Phone (704) 290-7527
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068.0099603 | VT | MD | Mental Health Counselor |
| 10653 | NC | MD | Professional Counselor |
| 002890-1 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412640000000",
"number": "1427162676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 SWEET SAMANTHA CT",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275265054",
"telephone_number": "704-290-7527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 SWEET SAMANTHA CT",
"city": "FUQUAY VARINA",
"state": "NC",
"postal_code": "275265054",
"telephone_number": "704-290-7527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAXENDALE",
"first_name": "JAMES",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PH.D., CTS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2014-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "068.0099603",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "002890-1",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "10653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fuquay Varina, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.