DR. BRECK BAKER (NPI# 1619411279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619411279 |
| Entity Type | Individual |
| Full Name | DR. BRECK BAKER |
| Credential | PMHNP -BC |
| Practice Address |
200 San Sebastian Vw Ste 2102 St Augustine FL 32084-8695 |
| Practice Telephone | 8005394228 |
| Practice Fax Number | 9042096288 |
| Mailing Telephone | 8005394228 |
| Mailing Fax Number | 9042096288 |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2019-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN 256580 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
APRN11001264 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
200 SAN SEBASTIAN VW STE 2102 |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32084-8695 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124291885 | Daniel Aaron Weinberg | Specialist | 200 San Sebastian Vw Ste 2102, St Augustine, FL 32084 | 2008-04-02 |
| 1053944389 | Christine Monahan Ventresca | Counselor | 200 San Sebastian Vw Ste 2102, St Augustine, FL 32084-8695 | 2020-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347599 | Cody Martyn | Pharmacist | 955 Fl-16, St. Augustine, FL 32084 | 2020-08-18 |
| 1912562471 | Kjcares Suportive Living Services | Case Manager/Care Coordinator | 20 First Street, Apt 5, St. Augustine, FL 32084 | 2019-05-09 |
| 1558841684 | Kevin D Roberts | Psychologist | 20 First Street Apt 5, St. Augustine, FL 32084 | 2018-08-17 |
| 1568954576 | Gwendolyn Marie Spong | Nurse Practitioner | 2703 N Ponce De Leon Blvd., Minute Clinic #3591, Area 4, Region 46, St. Augustine, FL 32084 | 2018-06-05 |
| 1770940116 | Marian L. Turner-sharpton, Lcsw | Social Worker | 17 Pacific St., Suite 2 (growth Pointe), St. Augustine, FL 32084 | 2016-01-15 |
| 1710358932 | Florida Laboratory Analysis, LLC | Clinical Medical Laboratory | 1690 Us Highway 1 S Ste D, St Augustine, FL 32084 | 2015-10-14 |
| 1780064774 | J Mae Transportation | Non-emergency Medical Transport (VAN) | 28 N Whitney St Apt 404, St Augustine, FL 32084 | 2015-06-04 |
| 1497154520 | Suzanne Smith Weed | Nurse Practitioner | 32 Mulberry Street, Saint Augustine, FL 32084 | 2014-08-14 |
| 1447684469 | Rachel Moran | Counselor | 162 Oneida Street, St. Augustine, FL 32084 | 2013-08-27 |
| 1932545993 | Matrix Medical, LLC | Durable Medical Equipment & Medical Supplies | 56 S Dixie Hwy Ste 1, St Augustine, FL 32084 | 2013-05-17 |
| Find all providers in zip 32084 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306463914 | Amy Michelle Brannon | Nurse Practitioner | 200 San Sebastian Vw # 2102, St Augustine, FL 32084-8695 | 2020-06-30 |
| 1104442953 | Ajla Hurem | Nurse Practitioner | 200 San Sebastian Vw, St Augustine, FL 32084-8695 | 2020-06-17 |
| 1669661658 | Stephanie Ann Crites | Nurse Practitioner | 1955 Us Highway 1 S, Suite C-2, St Augustine, FL 32086-3708 | 2007-10-16 |
| 1376559781 | Peggy A Marion | Nurse Practitioner | 1955 Us 1 S, Suite 200, St Augustine, FL 32086-3708 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295336832 | Marco Desouza | Nurse Practitioner | 10235 Avelar Ridge Dr, Riverview, FL 33578-7560 | 2020-11-02 |
| 1457950107 | Janet Rosemarie Walker | Nurse Practitioner | 9988 Sw 38th Ave, Ocala, FL 34476-4082 | 2020-10-23 |
| 1104425800 | Vijayalakshmi Kumaraguru | Nurse Practitioner | 102 Park Place Blvd Ste D1, Kissimmee, FL 34741-2358 | 2020-10-22 |
| 1356940217 | Smitha Ajesh | Nurse Practitioner | 9833 Westview Dr Apt 829, Coral Springs, FL 33076-2537 | 2020-10-21 |
| 1457959066 | Kecia Hicks | Nurse Practitioner | 691 Institution Rd, Defuniak Springs, FL 32433-1850 | 2020-10-15 |
| 1699372003 | Rosie Michel | Nurse Practitioner | 13000 Ne 12th Ave, North Miami, FL 33161-4305 | 2020-10-08 |
| 1952908352 | Karen Weinstock | Nurse Practitioner | 7148 Sportsmans Dr, North Lauderdale, FL 33068-5456 | 2020-10-08 |
| 1396342754 | Pamela Ziel | Nurse Practitioner | 545 Lakeside Cir, Sunrise, FL 33326-2136 | 2020-10-07 |
| 1922615608 | Urszula Dorfman | Nurse Practitioner | 1 Las Olas Cir Apt 609, Fort Lauderdale, FL 33316-1634 | 2020-09-28 |
| 1073129136 | Karen Harris | Nurse Practitioner | 28211 Church Rd, Brooksville, FL 34602-6232 | 2020-09-23 |
| Find all providers with the same taxonomy | ||||
| City | ST AUGUSTINE |
| Zip Code | 32084 |
Please comment or provide details below to improve the information on DR. BRECK BAKER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.