BAPTIST AGEWELL PHYSICIANS INC (NPI# 1710464946) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710464946 |
| Entity Type | Organization |
| Organization Name | BAPTIST AGEWELL PHYSICIANS INC |
| Practice Address |
1350 13th Ave S Ste 118-a Jacksonville Beach FL 32250-3203 |
| Mailing Address |
Po Box 3162 Salt Lake City UT 84110-3162 |
| Practice Telephone | 9042024600 |
| Practice Fax Number | 9042024639 |
| Mailing Telephone | 9042021032 |
| Mailing Fax Number | 9043734107 |
| Enumeration Date | 2018-07-20 |
| 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 | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306107099 | Baptist Agewell Physicians Inc | Family Medicine | 3563 Philips Hwy Ste 101, Jacksonville, FL 32207 | 2012-05-30 |
| 1023595105 | Baptist Agewell Physicians Inc | Family Medicine | 841 Prudential Dr Ste 180, Jacksonville, FL 32207-8350 | 2018-07-23 |
| Street Address |
1350 13TH AVE S STE 118-A |
| City | JACKSONVILLE BEACH |
| State | FL |
| Zip Code | 32250-3203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386129591 | Kelsey Ilene Keimig | Audiologist | 3200 S 3rd Street, Ste 101, Jacksonville, FL 32250 | 2018-10-03 |
| 1225529696 | Turning Tides Eating Disorder Treatment Center, LLC. | Clinic/Center | 4300 Marsh Landings Blvd. #101, Jacksonville Beach, FL 32250 | 2018-05-22 |
| 1528578820 | Dianne Frances Gay | Dental Hygienist | 1144 14th Street North, Jacksonville Beach, FL 32250 | 2017-10-02 |
| 1801324280 | Kailo Nutrition | Dietitian, Registered | 353 B 6th Street South, Jacksonville, FL 32250 | 2017-05-30 |
| 1275985368 | Shankeertha Sundaralingam | Dentist | 3316 3rd St S Ste 101, Jacksonville Beach, FL 32250 | 2016-07-13 |
| 1851777494 | Brooke Worthington Davidson | Audiologist | 1370 13th Ave S Ste 115, Jacksonville Beach, FL 32250 | 2015-08-05 |
| 1689059115 | Jenna Levine | Speech-Language Pathologist | 779 10th Avenue South, Jacksonville Beach, FL 32250 | 2015-07-27 |
| 1790176824 | Olivia Ingram Caswell | Acupuncturist | 2902 Isabella Boulevard, Suite 50, Jacksonville Beach, FL 32250 | 2015-02-11 |
| 1467859033 | Colleen Freeman | Physical Therapist | 1537 Penman Rd, Jacksonville, FL 32250 | 2014-11-26 |
| 1356750012 | Madelyn Jones | Physical Therapist | 1320 Roberts Drive, Jacksonville Beach, FL 32250 | 2014-08-07 |
| Find all providers in zip 32250 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087722 | Norma Leticia Goodrich | Internal Medicine | 19265 Nw 252nd St, Okeechobee, FL 34972-6966 | 2020-09-14 |
| 1356811897 | Lake Behavioral Health Management | Internal Medicine | 225 W Canton Ave Ste 600, Winter Park, FL 32789-3181 | 2018-11-27 |
| 1528549490 | Ultra Health Providers of Florida | Internal Medicine | 105 Asterbrooke Dr, Deland, FL 32724 | 2018-08-28 |
| 1659891018 | Pocketdoc Physicians Pa | Internal Medicine | 333 Se 2nd Ave Ste 2000, Miami, FL 33131-2185 | 2017-06-26 |
| 1003349549 | On Call Wound Care LLC | Internal Medicine | 12798 Forest Hill Blvd Ste 205b, Wellington, FL 33414-4768 | 2017-04-11 |
| 1154781284 | Verimed Health Group Land O' Lakes, LLC | Internal Medicine | 2638 Narnia Way, Ste 101, Land O Lakes, FL 34638-7231 | 2016-03-02 |
| 1083082895 | Edith Maria Ortega | Internal Medicine | 528 Oceanfront, Neptune Beach, FL 32266 | 2015-09-10 |
| 1881083020 | Arnold Jay Simon, M.d. | Internal Medicine | 3175 S Congress Ave Ste 305, Palm Springs, FL 33461-2562 | 2015-01-12 |
| 1912300575 | Geriatrics and Hospitalists Associates | Internal Medicine | 3255 Cypress Legends Cir Apt 433, Fort Myers, FL 33905-5516 | 2014-09-26 |
| 1396151809 | Susana Gonzalez, M.d., P.a. | Internal Medicine | 1225 Alton Road, Miami Beach, FL 33139 | 2014-07-03 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE BEACH |
| Zip Code | 32250 |
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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.