Individual provider Active NPI

Baxter Dixon Tharin, M.D.

  • Diagnostic Radiology Physician
  • Fort Stewart, GA
National Provider Identifier
1013177120
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME135337 Issued in FL
Practice address
1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone
(912) 435-5770
NPI assigned
Jun 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME135337 FL Primary
Diagnostic Radiology Physician 2085R0202X DR.0054157 CO
Diagnostic Radiology Physician 2085R0202X 0101246167 VA

Addresses

Primary practice location

1061 Harmon Ave
Fort Stewart, GA 31314-5641

Mailing address

1061 Harmon Ave
Fort Stewart, GA 31314-5641
Phone (912) 435-5770

Other practice location 1

5955 Zeamer Ave
Jber, AK 99506-3702
Phone (907) 580-3205

Other practice location 2

9582 W Colonial Dr
Lee B Cecil
Ocoee, FL 34761
Phone (407) 896-3055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, GA, SC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20141024000861 CO Practitioner - Diagnostic Radiology 4284867961 Reassigns benefits to 1 organization
I20210415000264 GA Practitioner - Diagnostic Radiology 4284867961 Reassigns benefits to 2 organizations
I20260529001181 SC Practitioner - Diagnostic Radiology 4284867961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Florida Radiology Associates PAGroup PAC ID 0941224612, 33 clinicians

Practice addresses (Care Compare)

540 Buckland Hall Rd
Richmond Hill, GA 31324-5325
Phone (850) 689-8100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0054157COMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
West Florida Radiology Associates PA Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Denver Health and Hospital Authority CurrentSince Mar 1, 2021 Accepting new patients
South Georgia Radiology Associates, LLC Diagnostic Radiology CurrentSince Mar 14, 2022 Accepting new patients
Denver Health and Hospital Authority CurrentSince Mar 1, 2021 Accepting new patients
Shelin Agrawal and Hyer PLLC Diagnostic Radiology Past Accepting new patients

Locations

777 Bannock St
#3240
Denver, CO 80204
Phone (303) 602-2714

777 Bannock St
Denver, CO 80204

151 E Redstone Ave
Crestview, FL 32539
Phone (850) 629-8515

160 Twin Springs Way
Defuniak Springs, FL 32435
Phone (850) 389-6955

163 E Tollison St
Baxley, GA 31513
Phone (912) 367-9847

116 W Thigpen Ave
Lakeland, GA 31635
Phone (229) 482-8440

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: btharin251229@direct.dhha.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1013177120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-5770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5955 Zeamer Ave",
            "address_purpose": "LOCATION",
            "city": "Jber",
            "state": "AK",
            "postal_code": "995063702",
            "country_code": "US",
            "telephone_number": "907-580-3205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9582 W Colonial Dr",
            "address_2": "Lee B Cecil",
            "address_purpose": "LOCATION",
            "city": "Ocoee",
            "state": "FL",
            "postal_code": "34761",
            "country_code": "US",
            "telephone_number": "407-896-3055",
            "fax_number": "407-826-1103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THARIN",
        "first_name": "BAXTER",
        "middle_name": "DIXON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME135337",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "DR.0054157",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "VA",
            "license": "0101246167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Stewart, GA

Sources for this page

Verify at the official NPI Registry.