Active NPI
Pamela Anne Baker, PT
- Pediatric Physical Therapist
- Lubbock, TX
National Provider Identifier
1770666554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 1053890
- Practice address
- 4601 66TH Street
Suite D
Lubbock, TX 79414-4828 - Phone
- (806) 793-3900
- Fax
- (806) 793-3937
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 1053890 | TX | Primary |
Addresses
Primary practice location
4601 66TH Street
Suite D
Lubbock, TX 79414-4828
Mailing address
4601 66TH Street
Suite D
Lubbock, TX 79414-4828
Phone (806) 793-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 84433T | Other | TX | BLUE CROSS BLUE SHIELD |
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 |
|---|---|---|---|
| 1053890 | TX | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186444800000",
"number": "1770666554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 66TH STREET",
"address_2": "SUITE D",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794144828",
"telephone_number": "806-793-3900",
"fax_number": "806-793-3937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4601 66TH STREET",
"address_2": "SUITE D",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794144828",
"telephone_number": "806-793-3900",
"fax_number": "806-793-3937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKER",
"first_name": "PAMELA",
"middle_name": "ANNE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "TX",
"license": "1053890",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "84433T",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.