NPIMap

Organization Active NPI

James D. Baker III, M.D., PA

Doing business as Nephrology Associates Of Northeast Florida

  • Nephrology Physician
  • Jacksonville, FL
National Provider Identifier
1437182896
Registry record updated Mar 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
J33212 Issued in FL
Legal business name
JAMES D. BAKER III, M.D., PA
Doing business as
Nephrology Associates Of Northeast Florida
Practice address
2 Shircliff Way
Suite 700 Depaul BLDG.
Jacksonville, FL 32204
Phone
(904) 389-5333
Fax
(904) 389-5332
NPI assigned
Jul 9, 2006
Last updated
Mar 31, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2020

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

Authorized official

Name
Ramesh M Kotihal, M.D.NPI 1811055080
Title
President and Treasurer
Phone
(904) 389-5333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X J33212 FL Primary

Addresses

Primary practice location

2 Shircliff Way
Suite 700 Depaul BLDG.
Jacksonville, FL 32204

Mailing address

2 Shircliff Way
Suite 700 Depaul BLDG.
Jacksonville, FL 32204
Phone (904) 389-5333

Other identifiers 2

IdentifierTypeStateIssuer
103412400MedicaidFL
269053500MedicaidFL

Other names 1

  • Nephrology Associates Of Northeast Florida Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000824 FL Part B Supplier - Clinic/Group Practice 9032011663 Receives reassigned benefits from 22 practitioners
Practice locations: Orange Park, FL; Middleburg, FL; Jacksonville Beach, FL; Jacksonville, FL; Hilliard, FL; Fleming Island, FL; Fernandina Beach, FL

National Provider Directory

National Provider Directory

Locations

1747 Baptist Clay Dr
Ste 310D
Fleming Island, FL 32003

12735 Gran Bay Pkwy W
Jacksonville, FL 32258
Phone (786) 647-4146

2 Shircliff Way
Ste 415
Jacksonville, FL 32204
Phone (904) 389-5333

7645 Merrill Rd
Ste 204
Jacksonville, FL 32277
Phone (904) 398-1111

836 Prudential Dr
Ste 804
Jacksonville, FL 32207

1895 Kingsley Ave
Ste 303
Orange Park, FL 32073
Phone (904) 272-6161

2040 Dan Proctor Dr
Saint Marys, GA 31558
Phone (912) 576-6200

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585612800000",
    "number": "1437182896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY",
            "address_2": "SUITE 700 DEPAUL BLDG.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32204",
            "telephone_number": "904-389-5333",
            "fax_number": "904-389-5332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SHIRCLIFF WAY",
            "address_2": "SUITE 700 DEPAUL BLDG.",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32204",
            "telephone_number": "904-389-5333",
            "fax_number": "904-389-5332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES D. BAKER III, M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A",
        "authorized_official_last_name": "KOTIHAL",
        "authorized_official_first_name": "RAMESH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT AND TREASURER",
        "authorized_official_telephone_number": "904-389-5333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "J33212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103412400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269053500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nephrology Associates Of Northeast Florida",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nephrology Associates Of Northeast Florida",
            "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 Mar 31, 2020; 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.