NPIMap

Organization Active NPI

Baptist ENT Specialists Inc

  • Otolaryngology Physician
  • Jacksonville, FL
National Provider Identifier
1114306024
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
BAPTIST ENT SPECIALISTS INC
Practice address
1650 Prudential Dr Ste 200
Jacksonville, FL 32207-8149
Phone
(904) 202-6082
Fax
(904) 390-7385
NPI assigned
May 26, 2015
Last updated
Mar 19, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Catherine Holloway
Title
Executive Director
Phone
(904) 202-5378

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X FL Primary

Addresses

Primary practice location

1650 Prudential Dr Ste 200
Jacksonville, FL 32207-8149

Mailing address

PO Box 746656
Atlanta, GA 30374-6656
Phone (904) 202-2092

Other identifiers 1

IdentifierTypeStateIssuer
004630400MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Baptist ENT Specialists Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

836 Prudential Dr
Ste 1601
Jacksonville, FL 32207
Phone (904) 396-2400

Practitioners & affiliated clinicians

Practitioners 6

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": "1432598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1114306024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746656",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746656",
            "telephone_number": "904-202-2092",
            "fax_number": "904-376-4075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 PRUDENTIAL DR STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078149",
            "telephone_number": "904-202-6082",
            "fax_number": "904-390-7385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST ENT SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-26",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "HOLLOWAY",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "904-202-5378"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004630400",
            "state": "FL"
        }
    ],
    "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 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.