NPIMap

Organization Active NPI

Coltman and Baughman Physical Therapy PA

  • Physical Therapy Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1962079467
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
COLTMAN AND BAUGHMAN PHYSICAL THERAPY PA
Practice address
14797 Philips Hwy # 205
Jacksonville, FL 32256-3746
Phone
(904) 853-5106
NPI assigned
Jun 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Authorized official

Name
Mark Henry Baughman, DPT, ATC, OCS
Title
Physical Therapist / Partner
Phone
(904) 853-5106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

14797 Philips Hwy # 205
Jacksonville, FL 32256-3746

Mailing address

350 13TH Ave S
Jacksonville Beach, FL 32250-5024
Phone (904) 853-5106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140910000689 FL Part B Supplier - Clinic/Group Practice 6305063488 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL; Jacksonville Beach, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Coltman and Baughman Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

14797 Philips Hwy
#205
Jacksonville, FL 32256
Phone (904) 853-5106

2370 3rd St S
#2
Jacksonville Beach, FL 32250
Phone (904) 853-5106

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1962079467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 13TH AVE S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322505024",
            "telephone_number": "904-853-5106",
            "fax_number": "904-853-5107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14797 PHILIPS HWY # 205",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563746",
            "telephone_number": "904-853-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLTMAN AND BAUGHMAN PHYSICAL THERAPY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "BAUGHMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST / PARTNER",
        "authorized_official_telephone_number": "904-853-5106",
        "authorized_official_credential": "DPT, ATC, OCS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.