Organization Active NPI

Baya Clinical Services LLC

  • Internal Medicine Physician
  • Lake City, FL
National Provider Identifier
1598412744
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BAYA CLINICAL SERVICES LLC
Practice address
780 SE Baya Dr
Lake City, FL 32025-5403
Phone
(386) 755-6677
NPI assigned
Mar 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Authorized official

Name
Ashley (Aj) S Ward, PHARMD
Title
Manager
Phone
(386) 288-5067

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

780 SE Baya Dr
Lake City, FL 32025-5403

Mailing address

780 SE Baya Dr
Lake City, FL 32025-5403
Phone (386) 755-6677

Other practice location 1

1465 W US Highway 90
Lake City, FL 32055-6136
Phone (386) 755-2233

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220414001241 FL Part B Supplier - Clinic/Group Practice 0042606246 Receives reassigned benefits from 1 practitioner
Practice locations: Lake City, FL

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
10D2270661Baya Clinical Services LLC780 SE Baya Drive, Lake City, FL 32025Certificate of waiverOct 18, 2026
10D2280677Baya Clinical Services LLC1465 W US Hwy 90 Ste 115, Lake City, FL 32055Certificate of waiverApr 24, 2027

National Provider Directory

National Provider Directory

Locations

1465 W US Highway 90
Lake City, FL 32055
Phone (386) 755-2233

780 SE Baya Dr
Lake City, FL 32025
Phone (386) 719-9952

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1646697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1598412744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 SE BAYA DR",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255403",
            "telephone_number": "386-755-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 SE BAYA DR",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255403",
            "telephone_number": "386-755-6677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1465 W US Highway 90",
            "address_purpose": "LOCATION",
            "city": "Lake City",
            "state": "FL",
            "postal_code": "320556136",
            "country_code": "US",
            "telephone_number": "386-755-2233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BAYA CLINICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-08",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "ASHLEY    (AJ)",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "386-288-5067",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.