NPIMap

Organization Active NPI

Baptist Specialty Physicians Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Jacksonville, FL
National Provider Identifier
1285149138
Registry record updated May 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
BAPTIST SPECIALTY PHYSICIANS INC
Practice address
836 Prudential Dr Ste 802
Jacksonville, FL 32207-8335
Phone
(904) 202-8290
Fax
(904) 202-8171
NPI assigned
Dec 13, 2017
Organization subpart
Yes
Parent organization
PAVILION HEALTH SERVICES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2021

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

Authorized official

Name
Thabata Batchelor
Title
Administrator
Phone
(904) 202-5048

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 802
Jacksonville, FL 32207-8335

Mailing address

PO Box 44047
Jacksonville, FL 32231-4047
Phone (904) 376-4083

Other names 1

  • Wolfson Children's Specialty Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Baptist Specialty Physicians Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

836 Prudential Dr
Ste 802
Jacksonville, FL 32207
Phone (904) 202-8290

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621555200000",
    "number": "1285149138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44047",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314047",
            "telephone_number": "904-376-4083",
            "fax_number": "904-391-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 802",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078335",
            "telephone_number": "904-202-8290",
            "fax_number": "904-202-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST SPECIALTY PHYSICIANS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PAVILION HEALTH SERVICES INC",
        "enumeration_date": "2017-12-13",
        "last_updated": "2021-05-21",
        "certification_date": "2021-05-21",
        "status": "A",
        "authorized_official_last_name": "BATCHELOR",
        "authorized_official_first_name": "THABATA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-202-5048"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wolfson Children's Specialty Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 21, 2021; 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.