Baz Family Medical Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R885984 Issued in MS

Legal business name

BAZ FAMILY MEDICAL CLINIC

Doing business as

Baz Family Medical Clinic

Practice address

4310 Chicot St
Pascagoula, MS 39581-4700

Phone

(717) 421-5490

NPI assigned

Apr 17, 2018

Last updated

Apr 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeanette Shabazz, NPNPI 1073916771

Title

Presiden

Phone

(717) 421-5490

Specialties & licenses 1

Addresses

Other names 1

• Baz Family Medical Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

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 3

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.

• Jeanette Shabazz

  • Family Nurse Practitioner
  • Ocean Springs, MS
  • NPI 1073916771
  Medicare reassignment NPD Authorized official
• Shekina T Dillon, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • D'Iberville, MS
  • NPI 1265918445
  Medicare reassignment NPD
• Kimberly Irby Dominique, FNP

  • Family Nurse Practitioner
  • Pascagoula, MS
  • NPI 1902496524
  NPD

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1508353384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7922 LONGWOOD DR",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395532629",
            "telephone_number": "717-421-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 CHICOT ST",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395814700",
            "telephone_number": "717-421-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAZ FAMILY MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A",
        "authorized_official_last_name": "SHABAZZ",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_title_or_position": "PRESIDEN",
        "authorized_official_telephone_number": "717-421-5490",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "R885984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baz Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Baz Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrew J. Barfield, MD
• Matthew Quin Barfield, D.O.
• Darryll Barksdale, M.D.
• Charlton Henry Barnes, M.D.
• Austin Baskin, PHYSICAL THERAPIST
• John H Bechtel, MD
• Stephen Bell
• Benchmark Physical Therapy of Mississippi LLC
• John Walter Benus, DPM
• Maria A Benvenutti-Payne, MPT

• Family Medicine Physician in Pascagoula, MS
• Providers in Pascagoula, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.