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General NPI Number Information
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NPI Number | 1679881536
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Entity Type | Organization
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Legal Business Name | BAPTIST PRIMARY CARE INC.
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 1210 VINTAGE WAY
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City | FERNANDINA BEACH
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State | FL
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Zip | 32034-0299
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Country | US
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Telephone | 904-261-0922
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Fax | 904-390-7477
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Provider Business Mailing Address
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Address Line | PO BOX 746638
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City | ATLANTA
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State | GA
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Zip | 30374-6638
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Country | US
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Telephone | 904-202-2092
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Fax | 904-376-4075
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MARSHA DONALDSON
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Credential |
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Telephone | 904-376-3703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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