NPIMap

Organization Active NPI

Baptist ENT Specialists Inc

  • Otolaryngology Physician
  • Jacksonville, FL
National Provider Identifier
1083913453
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
BAPTIST ENT SPECIALISTS INC
Practice address
14546 Old Saint Augustine Rd
Suite 401
Jacksonville, FL 32258-5468
Phone
(904) 268-5366
Fax
(904) 268-5457
NPI assigned
Mar 24, 2011
Last updated
Mar 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Authorized official

Name
Leeann Mengel
Title
Director
Phone
(904) 376-4275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X NU Primary

Addresses

Primary practice location

14546 Old Saint Augustine Rd
Suite 401
Jacksonville, FL 32258-5468

Mailing address

14546 Old Saint Augustine Rd
Suite 401
Jacksonville, FL 32258-5468
Phone (904) 268-5366

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110801000448 FL Part B Supplier - Clinic/Group Practice 4587833983 Receives reassigned benefits from 2 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1650 Prudential Dr
Ste 200
Jacksonville, FL 32207
Phone (904) 202-6028

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": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1083913453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14546 OLD SAINT AUGUSTINE RD",
            "address_2": "SUITE 401",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585468",
            "telephone_number": "904-268-5366",
            "fax_number": "904-268-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14546 OLD SAINT AUGUSTINE RD",
            "address_2": "SUITE 401",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322585468",
            "telephone_number": "904-268-5366",
            "fax_number": "904-268-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST ENT SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "MENGEL",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "904-376-4275"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.