Active NPI
Nathaniel Baker Jr.
- Occupational Therapy Assistant
- Winston Salem, NC
National Provider Identifier
1902367196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 6578
- Practice address
- 1900 W 1St St
Winston Salem, NC 27104-4220 - Phone
- (704) 701-3309
- NPI assigned
- Mar 29, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 6578 | NC | Primary |
Addresses
Primary practice location
1900 W 1St St
Winston Salem, NC 27104-4220
Mailing address
28 Beauregard Dr
Spencer, NC 28159-1956
Phone (704) 701-3309
Other practice location 1
1505 Bringle Ferry Rd
Salisbury, NC 28146-4776
Phone (704) 637-5585
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 |
|---|---|---|---|
| 6578 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553817600000",
"number": "1902367196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 BEAUREGARD DR",
"city": "SPENCER",
"state": "NC",
"postal_code": "281591956",
"telephone_number": "704-701-3309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 W 1ST ST",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271044220",
"telephone_number": "704-701-3309"
}
],
"practiceLocations": [
{
"address_1": "1505 Bringle Ferry Rd",
"address_purpose": "LOCATION",
"city": "Salisbury",
"state": "NC",
"postal_code": "281464776",
"country_code": "US",
"telephone_number": "704-637-5585",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAKER",
"first_name": "NATHANIEL",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-03-29",
"last_updated": "2019-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NC",
"license": "6578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.