NPIMap

Organization Active NPI

Southern Baptist Hospital of Florida, Inc

  • Clinical Medical Laboratory
  • Jacksonville, FL
National Provider Identifier
1972044857
Registry record updated Mar 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
800000149 Issued in FL
Legal business name
SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC
Practice address
800 Prudential Drive
Laboratory
Jacksonville, FL 32207
Phone
(904) 202-2006
Fax
(904) 346-0235
NPI assigned
Mar 13, 2017
Organization subpart
Yes
Parent organization
SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 13, 2017

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

Authorized official

Name
Mr. A. Hugh Greene
Title
President and Ceo
Phone
(904) 202-4011

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 800000149 FL Primary

Addresses

Primary practice location

800 Prudential Drive
Laboratory
Jacksonville, FL 32207

Mailing address

800 Prudential Drive
Jacksonville, FL 32207
Phone (904) 202-2016

Other identifiers 1

IdentifierTypeStateIssuer
100641-00MedicaidFL

Other names 1

  • Baptist Medical Center Jacksonville Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0268748Baptist Medical Center Jacksonville Clinical Lab800 Prudential Dr, Jacksonville, FL 32207AccreditationFeb 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
James Campbell18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

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

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1489363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489363200000",
    "number": "1972044857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DRIVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-202-2016",
            "fax_number": "904-346-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DRIVE",
            "address_2": "LABORATORY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32207",
            "telephone_number": "904-202-2006",
            "fax_number": "904-346-0235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN BAPTIST HOSPITAL OF FLORIDA, INC",
        "enumeration_date": "2017-03-13",
        "last_updated": "2017-03-13",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "A. HUGH",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "904-202-4011",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800000149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100641-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Medical Center Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.