NPIMap

Organization Active NPI

Anava Emergency Consultants LLC

  • Emergency Care Clinic/Center
  • Macclenny, FL
National Provider Identifier
1003698184
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
ANAVA EMERGENCY CONSULTANTS LLC
Practice address
159 N 3Rd St
Macclenny, FL 32063-2103
Phone
(904) 259-3151
NPI assigned
Oct 16, 2023
Last updated
Oct 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Grant P Barker, MDNPI 1477013555
Title
President
Phone
(727) 515-3119

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X NU Primary

Addresses

Primary practice location

159 N 3Rd St
Macclenny, FL 32063-2103

Mailing address

1640 Aberdeen St
Jacksonville, FL 32205-8636
Phone (727) 515-3119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240417001997 FL Part B Supplier - Clinic/Group Practice 7719326248 Receives reassigned benefits from 23 practitioners
Practice locations: Macclenny, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1697414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1003698184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 ABERDEEN ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322058636",
            "telephone_number": "727-515-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 N 3RD ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632103",
            "telephone_number": "904-259-3151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANAVA EMERGENCY CONSULTANTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-16",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-515-3119",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macclenny, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.