NPIMap

Organization Active NPI

Baptist ENT Specialists Inc

  • Otolaryngology Physician
  • Fleming Island, FL
National Provider Identifier
1700265998
Registry record updated Feb 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
BAPTIST ENT SPECIALISTS INC
Practice address
1747 Baptist Clay Rd
Suite 360
Fleming Island, FL 32003-8502
Phone
(904) 592-1068
Fax
(904) 541-4728
NPI assigned
May 21, 2015
Last updated
Feb 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2017

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

Authorized official

Name
Catherine Graham
Title
Administrator
Phone
(904) 202-5370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X FL Primary

Addresses

Primary practice location

1747 Baptist Clay Rd
Suite 360
Fleming Island, FL 32003-8502

Mailing address

PO Box 40767
Jacksonville, FL 32203-0767
Phone (904) 376-3707

Other identifiers 1

IdentifierTypeStateIssuer
004630400MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Baptist ENT Specialists 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.

Locations

1747 Baptist Clay Dr
Ste 360
Fleming Island, FL 32003
Phone (904) 592-1068

NPI Registry JSON

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

{
    "created_epoch": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485907200000",
    "number": "1700265998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40767",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322030767",
            "telephone_number": "904-376-3707",
            "fax_number": "904-391-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 BAPTIST CLAY RD",
            "address_2": "SUITE 360",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320038502",
            "telephone_number": "904-592-1068",
            "fax_number": "904-541-4728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST ENT SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2017-02-01",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-202-5370"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004630400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.