| Baker Community Health Center Inc | |
|
159 N 3rd St Macclenny FL 32063-2103 | |
| (904) 259-3151 | |
| (904) 259-3279 |
| Full Name | Baker Community Health Center Inc |
|---|---|
| Speciality | Emergency Medicine |
| Location | 159 N 3rd St, Macclenny, Florida |
| Authorized Official Name and Position | Tiffany Varnadoe (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7064372683 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Baker Community Health Center Inc 159 N 3rd St Macclenny FL 32063-2103 Ph: (904) 259-3151 | Baker Community Health Center Inc 159 N 3rd St Macclenny FL 32063-2103 Ph: (904) 259-3151 |
| NPI Number | 1396807319 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 12/17/2021 |
| Medicare PECOS PAC ID | 3779689807 |
|---|---|
| Medicare Enrollment ID | O20070728000111 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396807319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 207P00000X | Emergency Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeremie Joseph Young |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1003912635 PECOS PAC ID: 7517914443 Enrollment ID: I20080109000576 |
| Provider Name | Paul Jarczyk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952322125 PECOS PAC ID: 6608932249 Enrollment ID: I20090305000211 |
| Provider Name | Mark A Hardin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770544777 PECOS PAC ID: 7517911647 Enrollment ID: I20101021000066 |
| Provider Name | Kyle Monroe Knabb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922372788 PECOS PAC ID: 2264697622 Enrollment ID: I20120710000297 |
| Provider Name | Suresh Kumar T Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588669006 PECOS PAC ID: 3870490915 Enrollment ID: I20151209000462 |
| Provider Name | Aaron Butch Ward |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891107991 PECOS PAC ID: 2264653773 Enrollment ID: I20170628003378 |
| Provider Name | Latoya D Holton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821523713 PECOS PAC ID: 1759652746 Enrollment ID: I20170809003351 |
| Provider Name | Brandon P Olivieri |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1699064196 PECOS PAC ID: 0042571317 Enrollment ID: I20180301000371 |
| Provider Name | Katherine R Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346792769 PECOS PAC ID: 1254612203 Enrollment ID: I20200324000153 |
| Provider Name | Taylor Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861032419 PECOS PAC ID: 9537580659 Enrollment ID: I20200528000605 |
| Provider Name | Brent D Libby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821078346 PECOS PAC ID: 1557590593 Enrollment ID: I20201104001211 |
| Provider Name | Pushpjeet S Kanwar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912172149 PECOS PAC ID: 9830345305 Enrollment ID: I20210518001520 |
| Provider Name | Chelsea Blum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356071427 PECOS PAC ID: 4688057359 Enrollment ID: I20220812000304 |
| Provider Name | Magan Mona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295499937 PECOS PAC ID: 1850767039 Enrollment ID: I20221012002734 |
| Provider Name | Moayad Tarboush |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841668308 PECOS PAC ID: 6800187196 Enrollment ID: I20230717001932 |
| Provider Name | Benjamin T Yunk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982100038 PECOS PAC ID: 8729448766 Enrollment ID: I20230721001549 |
| Provider Name | Tiffany Braddy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760165013 PECOS PAC ID: 6709240120 Enrollment ID: I20230918002572 |
| Provider Name | Steven Larsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508953555 PECOS PAC ID: 7517965064 Enrollment ID: I20240802002629 |
| Provider Name | Jennifer Callie Maynor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194571158 PECOS PAC ID: 5294273082 Enrollment ID: I20240812001628 |
| Provider Name | Amanda S Hawthorne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104502145 PECOS PAC ID: 8628501533 Enrollment ID: I20241031000481 |
Baker Community Medical Practice Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 159 N 3rd St, Macclenny, FL 32063 Phone: 904-259-3151 Fax: 904-259-3279 | |
Comp Med Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 159 N 3rd St, Macclenny, FL 32063 Phone: 904-259-7185 | |
Tecson Family Practice Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 725 S 6th St, Maccle, Macclenny, FL 32063 Phone: 904-259-3150 Fax: 904-259-7890 | |
Millennium Physician Group Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 725 S 6th St, Macclenny, FL 32063 Phone: 904-259-3150 Fax: 904-259-7890 | |
Peter C. Jansen Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 159 N 3rd St, Macclenny, FL 32063 Phone: 904-259-7815 Fax: 904-259-4675 | |
Baker County Medical Services Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 159 N 3rd St, Macclenny, FL 32063 Phone: 904-259-3151 Fax: 904-259-3279 |