Organization Active NPI

Baptist Primary Care Inc

  • Pediatrics Physician
  • Jacksonville, FL
National Provider Identifier
1497364707
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BAPTIST PRIMARY CARE INC
Practice address
3945 San Jose Park Dr
Jacksonville, FL 32217-4612
Phone
(904) 731-3530
Fax
(904) 737-1548
NPI assigned
Jul 23, 2020
Last updated
Jul 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Authorized official

Name
Marsha Donaldson
Title
Vice President
Phone
(904) 376-3707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3945 San Jose Park Dr
Jacksonville, FL 32217-4612

Mailing address

PO Box 45443
Salt Lake City, UT 84145-0443
Phone (904) 202-1032

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0269422Baptist Primary Care, Inc3945 San Jose Park Dr, Jacksonville, FL 32217ComplianceNov 28, 2026

National Provider Directory

National Provider Directory
Tax ID family
Baptist Primary Care Inc43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595462400000",
    "number": "1497364707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45443",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841450443",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3945 SAN JOSE PARK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322174612",
            "telephone_number": "904-731-3530",
            "fax_number": "904-737-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A",
        "authorized_official_last_name": "DONALDSON",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "904-376-3707"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.