NPIMap

Organization Active NPI

Baptist Specialty Physicians Inc

  • Pediatric Cardiology Physician
  • Lake City, FL
National Provider Identifier
1851965164
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
BAPTIST SPECIALTY PHYSICIANS INC
Practice address
3650 NW Devane St
Lake City, FL 32055-8730
Phone
(904) 202-8550
Fax
(904) 393-7808
NPI assigned
May 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Authorized official

Name
Thabata Ford
Title
Vice President
Phone
(904) 391-5578

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Congenital Heart Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RA0002X
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Pediatric Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0202X Primary

Addresses

Primary practice location

3650 NW Devane St
Lake City, FL 32055-8730

Mailing address

PO Box 44047
Jacksonville, FL 32231-4047
Phone (904) 376-4083

National Provider Directory

National Provider Directory
Tax ID family
Baptist Specialty Physicians Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3650 NW Devane St
Lake City, FL 32055
Phone (386) 755-1221

NPI Registry JSON

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

{
    "created_epoch": "1621468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621468800000",
    "number": "1851965164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44047",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322314047",
            "telephone_number": "904-376-4083",
            "fax_number": "904-391-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 NW DEVANE ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320558730",
            "telephone_number": "904-202-8550",
            "fax_number": "904-393-7808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST SPECIALTY PHYSICIANS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-20",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "THABATA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "904-391-5578"
    },
    "taxonomies": [
        {
            "code": "207RA0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Adult Congenital Heart Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "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 May 20, 2021; 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.