BAPTIST AGEWELL PHYSICIANS INC NPI 1124788146

NPI Information

  • NPI: 1124788146
  • Provider Name: BAPTIST AGEWELL PHYSICIANS INC
  • Classification: Family Medicine - 207QG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Organization
  • CLIA Number: 10D2234970
  • Address: 700 3RD ST STE 102
    NEPTUNE BEACH, FL
    ZIP 32266
  • Phone: (904) 202-4243

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NPI Details

BAPTIST AGEWELL PHYSICIANS INC is a geriatric medicine family medicine in Neptune Beach, 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 1124788146. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

700 3RD ST STE 102
NEPTUNE BEACH, FL
ZIP 32266-082
Phone: (904) 202-4243
Fax: (904) 202-4639

The provider's authorized official is Elizabeth Tibbs .
The authorized official title is Executive Director and has the following contact phone number (904) 202-3283.

The CLIA number assigned to this NPI record is 10D2234970 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/20/2021 and was last updated on 3/3/2026.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language PathologistNo
2225X00000XOccupational TherapistNo
3207RG0300XInternal MedicineGeriatric MedicineNo
4207QG0300XFamily 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: 11/21/2025

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