Blaine Payne, Inc

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

OS9255 Issued in FL

Legal business name

BLAINE PAYNE, INC

Practice address

180 NW Haynes St
Madison, FL 32340-2010

Phone

(850) 973-1215

Fax

(866) 923-4163

NPI assigned

Feb 23, 2016

Last updated

Jun 30, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tammey Revels

Title

Business Manager

Phone

(850) 973-1215

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Theresa Blaine Baker Payne, D.O.

  • Geriatric Medicine (Family Medicine) Physician
  • Madison, FL
  • NPI 1306858956
  Medicare reassignment NPD

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1770943409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323410185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 NW HAYNES ST",
            "city": "MADISON",
            "state": "FL",
            "postal_code": "323402010",
            "telephone_number": "850-973-1215",
            "fax_number": "866-923-4163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAINE PAYNE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "REVELS",
        "authorized_official_first_name": "TAMMEY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "850-973-1215"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "OS9255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "SXJQY",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "HUMANA",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272752800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37137",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carl D Bartholomew, DC, MD
• Emily Rose Battillo
• Amy Elizabeth Beach, FNP-C
• Bee Mindful Psychiatry & Wellness, PLLC
• Judy Gray Bentley, LMT
• Blended Logistics LLC
• Debra Cooks Boatman, LPN
• Christie Bradfield, PHARMD
• Cindy Brown
• Felica Brown

• Geriatric Medicine (Family Medicine) Physician in Madison, FL
• Providers in Madison, FL by specialty
• Geriatric Medicine (Family Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.