Organization Active NPI

Thomas W Baird D C P a

  • Exclusive Provider Organization
  • Orange Park, FL
National Provider Identifier
1053614941
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
CH2410 Issued in FL
Legal business name
THOMAS W BAIRD D C P A
Practice address
1820 Park Ave
Orange Park, FL 32073-4913
Phone
(904) 264-2988
Fax
(904) 264-9374
NPI assigned
Dec 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Authorized official

Name
Dr. Thomas W Baird, DCNPI 1407841877
Title
Owner
Phone
(904) 264-2988

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
Exclusive Provider Organization 302F00000X CH2410 FL Primary

Addresses

Primary practice location

1820 Park Ave
Orange Park, FL 32073-4913

Mailing address

1820 Park Ave
Orange Park, FL 32073-4913
Phone (904) 264-2988

Other identifiers 1

IdentifierTypeStateIssuer
88173OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111122000256 FL Part B Supplier - Clinic/Group Practice 3072787407 Receives reassigned benefits from 1 practitioner
Practice locations: Orange Park, FL

National Provider Directory

National Provider Directory

Locations

1820 Park Ave
Orange Park, FL 32073
Phone (904) 264-2988

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1053614941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 PARK AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734913",
            "telephone_number": "904-264-2988",
            "fax_number": "904-264-9374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 PARK AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734913",
            "telephone_number": "904-264-2988",
            "fax_number": "904-264-9374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS W BAIRD D C P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "BAIRD",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-264-2988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "FL",
            "license": "CH2410",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "88173",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.