DR. THERESA BLAINE BAKER PAYNE (NPI# 1306858956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306858956 |
| Entity Type | Individual |
| Full Name | DR. THERESA BLAINE BAKER PAYNE |
| Other Name | DR. BLAINE BAKER PAYNE |
| Credential | D.O. |
| Practice Address |
180 Nw Haynes St Madison FL 32340-2010 |
| Mailing Address |
Po Box 185 Madison FL 32341-0185 |
| Practice Telephone | 8509731215 |
| Practice Fax Number | 8669234163 |
| Mailing Telephone | 8509731215 |
| Mailing Fax Number | 8669264163 |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2016-06-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | OS9255 | FL | Allopathic & Osteopathic Physicians |
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
OS9255 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | P00281257 | 01 |
| FL | 272752800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083705909 | Theresa Marie Payne | Nurse Practitioner | 3660 Park Sierra Dr, Suite 208, Riverside, CA 92505-3059 | 2006-09-27 |
| Street Address |
180 NW HAYNES ST |
| City | MADISON |
| State | FL |
| Zip Code | 32340-2010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770943409 | Blaine Payne, Inc | Family Medicine | 180 Nw Haynes St, Madison, FL 32340-2010 | 2016-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376016980 | Annie Laura Dyke | Registered Nurse | 213 Sw Third Ave, Madison, FL 32340 | 2019-01-07 |
| 1730698051 | Judith Khristian Sever-johnson | Registered Nurse | 218 Sw Third Avenue, Madison, FL 32340 | 2017-09-29 |
| 1265800437 | Maria Anchondo | Dentist | Ave. De La Raza #4722, Suite 3, Juarez, CHIHUAHUA 32340 | 2015-09-04 |
| 1508106063 | Family First Wellness Clinic, LLC | Family Medicine | 486 Sw Rutledge Street, Madison, FL 32340 | 2013-02-20 |
| 1306032073 | North Florida Pharmacy of Madison Inc. | Durable Medical Equipment & Medical Supplies | 139 Sw Macon St, Madison, FL 32340 | 2007-09-17 |
| 1295949444 | Roderick K Shaw IIi Dmd Pa | Dentist | 255 Ne Duval Ave, Madison, FL 32340 | 2007-05-09 |
| 1124159728 | Duramed Medical Services | Physiological Laboratory | 289 Sw Range Ave, Ste D, Madison, FL 32340 | 2007-03-08 |
| 1861595514 | Holiday Cvs LLC | Durable Medical Equipment & Medical Supplies | 407 East Base St, Madison, FL 32340 | 2006-09-07 |
| 1194701862 | Mos LLC | Nurse Practitioner | 256 Sw Washington Ave, Madison, FL 32340 | 2005-12-15 |
| 1699248203 | Katelynn Mae Croft | Licensed Practical Nurse | 213 Sw Third Ave, Madison, FL 32340 | 2019-01-07 |
| Find all providers in zip 32340 | ||||
| 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 |
|---|---|---|---|---|
| 1770943409 | Blaine Payne, Inc | Family Medicine | 180 Nw Haynes St, Madison, FL 32340-2010 | 2016-02-23 |
| 1184697898 | Kenneth C. Dozier | Family Medicine | 1210 Briarville Rd, Bldg F, Madison, TN 37115-5141 | 2006-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821620618 | Heather J Cappello LLC | Family Medicine | 2571 Dick Wilson Dr, Sarasota, FL 34240-8722 | 2020-02-10 |
| 1225682784 | Brevard Geriatrics, LLC | Family Medicine | 720 E New Haven Ave Suite 11, Melbourne, FL 32901-5474 | 2019-08-01 |
| 1922562933 | Bless Medical Center Corp | Family Medicine | 440 E Sample Road Suite 107, Pompano Beach, FL 33064 | 2019-01-23 |
| 1730682642 | Centennial Medical Group | Family Medicine | 1341 Bedford Drive, Melbourne, FL 32940 | 2018-03-16 |
| 1184137929 | Saint George Medical Center Inc | Family Medicine | 1118 Hospital Rd, Fort Walton Beach, FL 32547-6742 | 2017-11-15 |
| 1750835211 | Gainesville Geriatric Rehabilitation Medicine LLC | Family Medicine | 5002 Nw 15th Pl, Gainesville, FL 32605-4555 | 2016-08-12 |
| 1033570171 | Reliance Med, LLC | Family Medicine | 8450 Reymont St, Orlando, FL 32827-7430 | 2016-03-17 |
| 1013375062 | Kravitz Physician Services, P.a. | Family Medicine | 5150 Nw 82nd Ter, Coral Springs, FL 33067-2811 | 2016-02-05 |
| 1972968089 | Wm R George II Md Pa | Family Medicine | 327 Plaza Real Ste 307, Boca Raton, FL 33432-3944 | 2015-12-17 |
| 1710369020 | Robert N. Baskin, Md, P.a. | Family Medicine | 2108 N Golfview Dr, Plant City, FL 33566-6768 | 2015-06-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. THERESA BLAINE BAKER PAYNE.
| 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.