BAPTIST AGEWELL PHYSICIANS INC (NPI# 1023595105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023595105 |
| Entity Type | Organization |
| Organization Name | BAPTIST AGEWELL PHYSICIANS INC |
| Practice Address |
841 Prudential Dr Ste 180 Jacksonville FL 32207-8350 |
| Mailing Address |
Po Box 3162 Salt Lake City UT 84110-3162 |
| Practice Telephone | 9042024600 |
| Practice Fax Number | 9042024639 |
| Mailing Telephone | 9042021032 |
| Mailing Fax Number | 9043764107 |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-12-12 |
| Authorized Official Name | MARSHA DONALDSON (VICE PRESIDENT) |
| Authorized Official Telephone | 9043763703 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710464946 | Baptist Agewell Physicians Inc | Internal Medicine | 1350 13th Ave S Ste 118-a, Jacksonville Beach, FL 32250-3203 | 2018-07-20 |
| 1306107099 | Baptist Agewell Physicians Inc | Family Medicine | 3563 Philips Hwy Ste 101, Jacksonville, FL 32207 | 2012-05-30 |
| Street Address |
841 PRUDENTIAL DR STE 180 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912975426 | Anna Orman | Family Medicine | 841 Prudential Dr Ste 180, Jacksonville, FL 32207 | 2006-03-09 |
| 1760750566 | Amy Elizabeth Harp | Nurse Practitioner | 841 Prudential Dr Ste 180, Jacksonville, FL 32207-8350 | 2011-12-07 |
| 1508142753 | Ashlee R Loewen | Nurse Practitioner | 841 Prudential Dr Ste 180, Jacksonville, FL 32207-8350 | 2011-11-01 |
| 1972894921 | Raphael Tito Balbino | Family Medicine | 841 Prudential Dr Ste 180, Attn: Credentialing Specialist, Jacksonville, FL 32207-8350 | 2011-04-26 |
| 1255647715 | Vanessa Seiglie Quinones | Internal Medicine | 841 Prudential Dr Ste 180, Jacksonville, FL 32207-8350 | 2010-08-23 |
| 1639480114 | Anne E Yates | Nurse Practitioner | 841 Prudential Dr Ste 180, Jacksonville, FL 32207-8350 | 2010-06-29 |
| 1881644425 | Patricia A. Philips | Nurse Practitioner | 841 Prudential Dr Ste 180, Credentialing Department, Jacksonville, FL 32207-8350 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306107099 | Baptist Agewell Physicians Inc | Family Medicine | 3563 Philips Hwy Ste 101, Jacksonville, FL 32207 | 2012-05-30 |
| 1316273535 | Zhi Yu, Md, Pllc | Family Medicine | 4221 Stacey Rd E, Jacksonville, FL 32250-2100 | 2009-10-22 |
| 1306092549 | Coastal Mobile Medical Doctor, Pa | Family Medicine | 203 Stagecoach Dr, Jacksonville, NC 28546-9617 | 2008-08-07 |
| 1417065236 | Narender D Arcot | Family Medicine | 31 Office Park Dr, Jacksonville, NC 28546-3219 | 2006-08-29 |
| 1679513477 | David J Samara | Family Medicine | 6555 Chester Ave Ste 1, Jacksonville, FL 32217-2279 | 2006-06-08 |
| 1518934272 | Leonardo Sison Delrosario | Family Medicine | 225 W Ashley St, Jacksonville, FL 32202-4141 | 2006-03-01 |
| 1770575052 | Belton Craig Ray | Family Medicine | 2627 Riverside Ave, Jacksonville, FL 32204-4712 | 2005-08-22 |
| 1124024310 | Eugene Rawson Griffin IIi | Family Medicine | 3627 University Blvd S, Ste 615, Jacksonville, FL 32216-7401 | 2005-06-22 |
| 1679931372 | Jax Visiting Medical Providers LLC | Family Medicine | 9957 Moorings Dr, 204, Jacksonville, FL 32257-2412 | 2016-02-09 |
| 1831534874 | Christina Bungo | Family Medicine | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2013-05-03 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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| 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.