Individual provider Active NPI

Matthew David Barker, MD

  • Emergency Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1689653651
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
200400185 Issued in NC
Practice address
2080 Child Street
Emergency Medicine Department
Jacksonville, FL 32214-0001
Phone
(904) 542-7345
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C131787 CA
Aerospace Medicine Physician 2083A0100X 200400185 NC
Emergency Medicine Physician 207P00000X 200400185 NC Primary

Addresses

Primary practice location

2080 Child Street
Emergency Medicine Department
Jacksonville, FL 32214-0001

Mailing address

2080 Child Street
Emergency Medicine Department
Jacksonville, FL 32214-0001
Phone (904) 542-7345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120425000002 NC Practitioner - Emergency Medicine 4587826359 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Wake Forest University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1917 W Park Drivce
N Wilkesboro, NC 28659-3506
Phone (336) 667-3762

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
131787CAMDMarriage & Family Therapist
C131787CAMDEmergency Medicine Physician
200400185NCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Aug 1, 2022 Accepting new patients

Locations

1917 W Park Dr
North Wilkesboro, NC 28659
Phone (336) 903-0147

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: mbarker2754910@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1689653651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 CHILD STREET",
            "address_2": "EMERGENCY MEDICINE DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322140001",
            "telephone_number": "904-542-7345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 CHILD STREET",
            "address_2": "EMERGENCY MEDICINE DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322140001",
            "telephone_number": "904-542-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARKER",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "C131787",
            "primary": false
        },
        {
            "code": "2083A0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Aerospace Medicine",
            "state": "NC",
            "license": "200400185",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "200400185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.