Baymeadows Primary Care, INC.
Family Medicine in Jacksonville, FL. Organization (NPI-2).
Details
- NPI
- 1174512701
- Entity type
- Organization (NPI-2)
- Legal business name
- Baymeadows Primary Care, INC.
- Organization subpart
- No
- Enumeration date
- Oct 17, 2005
- Last updated
- Mar 14, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | ME71382 | FL | Yes |
| 207R00000X | Internal Medicine | ME81517 | FL |
Other names
- Baymeadows Healthcare (Doing Business As)
Practice location
10058 Baymeadows RdJacksonville, FL 32256-7177
Phone 904-636-5400 · Fax 904-928-0654
Mailing address
10058 Baymeadows RdJacksonville, FL 32256-7177
Phone 904-636-5400 · Fax 904-928-0654
Authorized official
S. Awais Imam
Practice Administrator/ Cfo
9046365400
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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