Baker County Medical Services, Inc
Organization Active NPI Emergency Medicine Physician · Macclenny, FL
NPI 1578822508 · NPPES record last updated Jun 21, 2021
Key facts
- NPI
- 1578822508
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- BAKER COUNTY MEDICAL SERVICES, INC
- Practice address
- 159 N 3Rd St
Macclenny, FL 32063-2103 - Phone
- (904) 259-7815
- NPI assigned
- May 11, 2012
- Organization subpart
- No
Authorized official
- Name
- Tiffany Varnadoe
- Title
- Chief Executive Officer
- Phone
- (904) 259-3151
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 4
Practitioners 31
-
Ahmed Yousif Abdelmagid, M.D.
-
Chelsea Allen, DO
-
Paul Jarczyk, MD
-
Semir Karic, MD
-
Alexandra Mannix, M.D.
-
Brendan McGowan, DO
-
Benjamin Douglas Moser, M.D., M.P.H.
-
Roberta S Santos, MD
-
Andrew Schmidt, D.O.
-
Ronya Silmi, MD
-
Aaron Butch Ward, M.D.
-
Ashton Federico, DO
-
James O Hill II, DO
-
Tyler Tantisook, MD
-
Charles John Ussery, D.O.
-
Cameron Scott Cushenbery, CRNA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
All facility ownership & control disclosures 2
| Facility | Type | Role | Since |
|---|---|---|---|
| Ed Fraser Memorial Hospital |
Hospital | Operational/Managerial Control (100%) | Oct 1, 1993 |
| W Frank Wells Nursing Home |
Skilled nursing facility | Operational/Managerial Control | Sep 13, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120619000212 | FL | Part B Supplier - Clinic/Group Practice | 6103710264 |
Receives reassigned benefits from 24 practitioners Practice locations: Macclenny, FL |
National Provider Directory
- Tax ID family
- Baker County Med SVCS Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes |
Addresses
Primary practice location
159 N 3Rd St
Macclenny, FL 32063-2103
Mailing address
6880 W Snowville Rd
Suite 210
Brecksville, OH 44141-3254
Other providers in Macclenny, FL
- Baker County Hospital Authority
- Baker County Medical Services Inc
- Baker County Medical Services Inc
- Baker County Medical Services Inc.
- Baker County Medical Services, Inc
- Baker County School Board
- Baker County School Board
- Baker County School Board
- Baker County School Board
- Baker County School Board
All providers in Macclenny, FL · Emergency Medicine Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.