Individual provider Active NPI

Jarius Lamon R. Anderson-Baylor

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1801274766
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME152773 Issued in FL
Practice address
7628 103Rd St Ste 10
Jacksonville, FL 32210-8719
Phone
(904) 869-2595
Fax
(855) 576-4109
NPI assigned
May 12, 2015
Last updated
May 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME152773 FL Primary
Family Medicine Physician 207Q00000X 57189 TN

Addresses

Primary practice location

7628 103Rd St Ste 10
Jacksonville, FL 32210-8719

Mailing address

102 Woodmont Blvd Ste 600
Nashville, TN 37205-5250
Phone (888) 987-1151

Other practice location 1

1215 Dunn Ave
Jacksonville, FL 32218-6330
Phone (904) 757-1998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200330002261 TN Practitioner - Family Practice 4880985134
I20211217001737 FL Practitioner - Family Practice 4880985134 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME152773FLMDFamily Medicine Physician
57189TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Archwell Health Medical of Florida, LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

4520 E Bay Dr
Clearwater, FL 33764
Phone (727) 405-7188

543 Tamiami Trl S
Venice, FL 34285
Phone (941) 837-8002

102 Woodmont Blvd
Ste 600
Nashville, TN 37205

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1801274766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WOODMONT BLVD STE 600",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372055250",
            "telephone_number": "888-987-1151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7628 103RD ST STE 10",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322108719",
            "telephone_number": "904-869-2595",
            "fax_number": "855-576-4109"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Dunn Ave",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322186330",
            "country_code": "US",
            "telephone_number": "904-757-1998",
            "fax_number": "904-696-7462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON-BAYLOR",
        "first_name": "JARIUS",
        "middle_name": "LAMON R.",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-12",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME152773",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "57189",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.