Organization Active NPI

B a R Medical Corporation

  • Geriatric Medicine (Internal Medicine) Physician
  • Jasper, FL
National Provider Identifier
1063704096
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME100798 Issued in FL
Legal business name
B A R MEDICAL CORPORATION
Practice address
413 5TH Ave NW
Jasper, FL 32052-7801
Phone
(386) 792-2985
Fax
(386) 792-0833
NPI assigned
May 10, 2011
Last updated
Jun 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Authorized official

Name
Anjana Rana, MDNPI 1114199171
Title
Owner
Phone
(386) 208-1200

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME100798 FL Primary

Addresses

Primary practice location

413 5TH Ave NW
Jasper, FL 32052-7801

Mailing address

609 5TH St SW Ste 5
Live Oak, FL 32064-2239
Phone (386) 208-1200

Other identifiers 1

IdentifierTypeStateIssuer
ME100798OtherFLMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221017002329 FL Part B Supplier - Clinic/Group Practice 2163898198 Receives reassigned benefits from 1 practitioner
Practice locations: Live Oak, FL

National Provider Directory

National Provider Directory

Locations

609 5th St SW
Ste 5
Live Oak, FL 32064
Phone (386) 208-1200

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1063704096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 5TH ST SW STE 5",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320642239",
            "telephone_number": "386-208-1200",
            "fax_number": "386-208-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 5TH AVE NW",
            "city": "JASPER",
            "state": "FL",
            "postal_code": "320527801",
            "telephone_number": "386-792-2985",
            "fax_number": "386-792-0833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B A R MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "RANA",
        "authorized_official_first_name": "ANJANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-208-1200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME100798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME100798",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.