NPIMap

Organization Active NPI

Baptist Neurology Inc

  • Neurology Physician
  • Jacksonville, FL
National Provider Identifier
1578795241
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
BAPTIST NEUROLOGY INC
Practice address
2736 University Blvd W
Suite 3
Jacksonville, FL 32217-2179
Phone
(904) 733-4262
Fax
(904) 636-5786
NPI assigned
Aug 14, 2009
Last updated
Jun 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Authorized official

Name
Earl B Mally
Title
Senior Vice President
Phone
(904) 376-4275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary

Addresses

Primary practice location

2736 University Blvd W
Suite 3
Jacksonville, FL 32217-2179

Mailing address

PO Box 41113
Jacksonville, FL 32203-1113
Phone (904) 376-4400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100923000562 FL Part B Supplier - Clinic/Group Practice 0345366704 Receives reassigned benefits from 63 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Jacksonville Beach, FL; Fleming Island, FL; Fernandina Beach, FL

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Baptist Neurology Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1250208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277424000000",
    "number": "1578795241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41113",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322031113",
            "telephone_number": "904-376-4400",
            "fax_number": "904-391-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2736 UNIVERSITY BLVD W",
            "address_2": "SUITE 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172179",
            "telephone_number": "904-733-4262",
            "fax_number": "904-636-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST NEUROLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-14",
        "last_updated": "2010-06-25",
        "status": "A",
        "authorized_official_last_name": "MALLY",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "904-376-4275"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "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 Jun 25, 2010; 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.