Max Russell Baldwin Jr., PAC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

003194 Issued in GA

Practice address

611 E. Villanow St.
Lafayette, GA 30728

Phone

(706) 638-1606

Fax

(706) 638-9987

NPI assigned

Oct 17, 2006

Last updated

Dec 19, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, TN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Midwestern University College of Dental Medicine, Glendale, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Memorial Health Partners Foundation IncGroup PAC ID 8022919570, 458 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091
• Commonspirit-Memorial Hospital-North Georgia Hospital, Ringgold, GA, CCN 110236

Merit-based Incentive Payment System (MIPS)

Final score

94.27 of 100Reported as apm

Quality

92.6

Promoting interoperability

93.23

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maxbaldwin@tnmhpf.allscriptsdirect.net
• Direct secure messaging: mbaldwin132748@direct.stlukeshealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Memorial Health Partners Foundation, Inc

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1922053545

  Family Medicine, GA

  Medicare reassignment Care Compare group NPD
• Memorial Health Partners Foundation Inc

  dba CHI Memorial Family Practice Associates - Lafayette

  • Rural Health Clinic/Center
  • La Fayette, GA
  • NPI 1760632780

  Family Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• CHI Memorial Hospital - Georgia

  • General Acute Care Hospital
  • Ringgold, GA
  • NPI 1356860621
  Care Compare affiliation
• Memorial Health Care System Inc.

  dba Memorial Hospital Hixson

  • General Acute Care Hospital
  • Hixson, TN
  • NPI 1083778633
  Care Compare affiliation
• Memorial Health Care System Inc.

  dba Memorial Hospital

  • General Acute Care Hospital
  • Chattanooga, TN
  • NPI 1255428736
  Care Compare affiliation

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1316028467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 E. VILLANOW ST.",
            "city": "LAFAYETTE",
            "state": "GA",
            "postal_code": "30728",
            "telephone_number": "706-638-1606",
            "fax_number": "706-638-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E. VILLANOW ST.",
            "city": "LAFAYETTE",
            "state": "GA",
            "postal_code": "30728",
            "telephone_number": "706-638-1606",
            "fax_number": "706-638-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALDWIN",
        "first_name": "MAX",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "003194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith A Anderson, MD
• Kay Anderson
• Candace Asher
• Beatrice Askew
• Karyl D Baker, LPC
• Jessica Anne Banks
• Eric J Betts, M.D.
• Kelly Blevins
• Morgan Boles
• Ernest Lee Bowling, O.D.

• Family Medicine Physician in La Fayette, GA
• Providers in La Fayette, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.