Kanika Lanese Baker

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

18438613 Issued in MN

Practice address

7240 Brooklyn Blvd Ste 150
Brooklyn Park, MN 55429-1274

Phone

(888) 507-6235

NPI assigned

Nov 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1619578648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12526 74TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695290",
            "telephone_number": "612-458-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7240 BROOKLYN BLVD STE 150",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554291274",
            "telephone_number": "888-507-6235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "KANIKA",
        "middle_name": "LANESE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "MN",
            "license": "18438613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Bana Medical Supplies

• Prosthetic/Orthotic Supplier in Brooklyn Park, MN
• Providers in Brooklyn Park, MN by specialty
• Prosthetic/Orthotic Supplier in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.