Individual provider Active NPI

Regina Marlene Baker, OTR/L

  • Occupational Therapist
  • Fort Walton Beach, FL
National Provider Identifier
1578066932
Registry record updated Mar 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT18896 Issued in FL
Practice address
405 Racetrack Rd NE Ste 101
Fort Walton Beach, FL 32547-3960
Phone
(850) 863-4747
Fax
(850) 863-4658
NPI assigned
Mar 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT18896 FL Primary

Addresses

Primary practice location

405 Racetrack Rd NE Ste 101
Fort Walton Beach, FL 32547-3960

Mailing address

405 Racetrack Rd NE Ste 101
Fort Walton Beach, FL 32547-3960
Phone (850) 863-4747

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT18896FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Group, PC Occupational Therapist CurrentSince Sep 12, 2022 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc CurrentSince Sep 25, 2023 Accepting new patients
Integrated Rehabilitation Group, PC CurrentSince Sep 12, 2022 Accepting new patients
Physioworks Silverdale PLLC CurrentSince Mar 20, 2023 Accepting new patients
Kitsap Physical Therapy and Sports Clinic PS Inc Occupational Therapist CurrentSince Sep 25, 2023 Accepting new patients

Locations

991 NE Riddell Rd
Bremerton, WA 98310
Phone (360) 373-2225

10207 19th Ave SE
Everett, WA 98208
Phone (425) 337-3166

403 W Stanley St
Granite Falls, WA 98252
Phone (360) 691-4835

4220 132nd St SE
Ste 101
Mill Creek, WA 98012
Phone (425) 316-8046

2400 NW Myhre Rd
Ste 101
Silverdale, WA 98383
Phone (360) 598-3764

2400 NW Myhre Rd
Ste 102
Silverdale, WA 98383
Phone (360) 598-3764

9399 Ridgetop Blvd NW
Ste 102
Silverdale, WA 98383
Phone (360) 900-2626

9399 Ridgetop Blvd NW
Ste 101
Silverdale, WA 98383
Phone (360) 516-1210

Organizations & group practices 5

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": "1520899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520899200000",
    "number": "1578066932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 RACETRACK RD NE STE 101",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325473960",
            "telephone_number": "850-863-4747",
            "fax_number": "850-863-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 RACETRACK RD NE STE 101",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325473960",
            "telephone_number": "850-863-4747",
            "fax_number": "850-863-4658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "REGINA",
        "middle_name": "MARLENE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-13",
        "last_updated": "2018-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT18896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2018; 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.