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BAPTIST AGEWELL PHYSICIANS INC NPI 1679240337


NPI Information

NPI: 1679240337
Provider Name: BAPTIST AGEWELL PHYSICIANS INC
Classification: Family Medicine - 207QG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 10D2274666

Address:
98 NOCATEE VILLAGE DR
PONTE VEDRA, FL
ZIP 32081
Phone: (904) 202-4243
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BAPTIST AGEWELL PHYSICIANS INC is a geriatric medicine family medicine in Ponte Vedra, FL. The provider is a family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. BAPTIST AGEWELL PHYSICIANS INC NPI is 1679240337. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

98 NOCATEE VILLAGE DR
PONTE VEDRA, FL
ZIP 32081-152
Phone: (904) 202-4243
Fax: (904) 202-4639

The provider's authorized official is Marsha Donaldson .
The authorized official title is Vice President and has the following contact phone number (904) 202-2141.

The CLIA number assigned to this NPI record is 10D2274666 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2021 and was last updated on 8/30/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RG0300XInternal MedicineGeriatric MedicineNo
2207QG0300XFamily MedicineGeriatric MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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