Individual provider Active NPI

Kathryn Leann Baker, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • Jbsa-Lackland, TX
National Provider Identifier
1770835001
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
OT.0005070 Issued in CO
Practice address
1100 Wilford Hall Loop
Sgco Occupational Therapy Clinic
Jbsa-Lackland, TX 78236-2502
Phone
(210) 292-5010
NPI assigned
Oct 10, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X OT.0005070 CO Primary

Addresses

Primary practice location

1100 Wilford Hall Loop
Sgco Occupational Therapy Clinic
Jbsa-Lackland, TX 78236-2502

Mailing address

1100 Wilford Hall Loop
Sgco Occupational Therapy Clinic
Jbsa-Lackland, TX 78236-0000
Phone (210) 292-5010

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

LicenseStateTypeSpecialty
OT.0005070COMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1349827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1770835001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "address_2": "SGCO OCCUPATIONAL THERAPY CLINIC",
            "city": "JBSA-LACKLAND",
            "state": "TX",
            "postal_code": "782360000",
            "telephone_number": "210-292-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WILFORD HALL LOOP",
            "address_2": "SGCO OCCUPATIONAL THERAPY CLINIC",
            "city": "JBSA-LACKLAND",
            "state": "TX",
            "postal_code": "782362502",
            "telephone_number": "210-292-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "KATHRYN",
        "middle_name": "LEANN",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-10",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "CO",
            "license": "OT.0005070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jbsa-Lackland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.