Beaches Family Medicine PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS0004709 Issued in FL

Legal business name

BEACHES FAMILY MEDICINE PA

Practice address

228 6TH Ave S
Jacksonville Beach, FL 32250-6634

Phone

(904) 247-1911

Fax

(904) 247-9736

NPI assigned

Mar 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Vaughn E Dobalian, M.D.NPI 1245260199

Title

Physician and Owner

Phone

(904) 247-1911

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vaughn Eric Dobalian, MD

  • Family Medicine Physician
  • Jacksonville Beach, FL
  • NPI 1245260199
  Medicare reassignment NPD Authorized official
• Michael Haghighi, M.D.

  • Family Medicine Physician
  • Englewood, FL
  • NPI 1770508707
  NPD (past)
• Karen Watts McCarthy, M.D.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1831125871
  NPD (past)
• Millicent Tanner, R.D.,C.D.E.

  • Registered Dietitian
  • Jacksonville Beach, FL
  • NPI 1467495242
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1407986920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 6TH AVE S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506634",
            "telephone_number": "904-247-1911",
            "fax_number": "904-247-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 6TH AVE S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506634",
            "telephone_number": "904-247-1911",
            "fax_number": "904-247-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACHES FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "DOBALIAN",
        "authorized_official_first_name": "VAUGHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN AND OWNER",
        "authorized_official_telephone_number": "904-247-1911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0004709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beaches Counseling & Therapy
• Beaches Ear Nose & Throat
• Beaches Ear, Nose and Throat, PA
• Beaches Eye Center, PA
• Beaches Facial and Nasal Surgery Center
• Beaches Healthcare, P.a.
• Beaches Nature Therapy LLC
• Beaches Neurology Clinic
• Beaches Open MRI, LLC
• Beaches Oral Maxillofacial Surgery, PLLC

• Family Medicine Physician in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.