DOPSON FAMILY MEDICAL CENTER (BAKER COMMUNITY MEDICAL PRACTICE INC) NPI 1003009291

Clinic/Center in Macclenny, FL

NPI 1003009291 Organization Clinic/Center CLIA Number 10D2044368 CLIA Certificate of Waiver

About DOPSON FAMILY MEDICAL CENTER (BAKER COMMUNITY MEDICAL PRACTICE INC)

Dopson Family Medical Center (baker Community Medical Practice Inc) is a provider established in Macclenny, Florida specializing in clinic/center. The NPI number of Dopson Family Medical Center (baker Community Medical Practice Inc) is 1003009291 and was assigned on August 2007. The practitioner's primary taxonomy code is 261Q00000X. The provider is registered as an organization and their NPI record was last updated 14 years ago. The provider's is doing business as Dopson Family Medical Center. The authorized official of this NPI record is Mr. Dennis Ray Markos (Chief Executive Officer)

The CLIA number of Dopson Family Medical Center is 10D2044368 registered as a "community clinic" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Dopson Family Medical Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003009291

Provider NameDOPSON FAMILY MEDICAL CENTER (BAKER COMMUNITY MEDICAL PRACTICE INC)
Provider Location Address159 N 3RD ST MACCLENNY, FL 32063
Provider Mailing Address159 N 3RD ST MACCLENNY, FL 32063
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NameDOPSON FAMILY MEDICAL CENTER
Other Name TypeDoing Business As (3)
Enumeration Date08-22-2007
Last Update Date08-22-2007


Primary Taxonomy

Taxonomy Code261Q00000X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
Taxonomy DescriptionA facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Business Address

DOPSON FAMILY MEDICAL CENTER
159 N 3RD ST
MACCLENNY, FL
ZIP 32063
Phone: (904) 259-3151
Fax: (904) 259-3279

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Mailing Address

DOPSON FAMILY MEDICAL CENTER
159 N 3RD ST
MACCLENNY, FL
ZIP 32063
Phone: (904) 259-3151
Fax: (904) 259-3279



Authorized Official

Authorized Official NameMR. DENNIS RAY MARKOS
Authorized Official TitleCHIEF EXECUTIVE OFFICER
Authorized Official Phone(904) 259-3151

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003009291 is:

CLIA Number10D2044368
Facility TypeCOMMUNITY CLINIC
Certificate TypeCertificate of Waiver

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1639139116 GARY DOPSON MD
Individual
Family Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 388-3351
1770544777 MARK HARDIN DO
Individual
Family Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-7815
1194787671COMP MED INC.
Organization
Family Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-7185
1184682049DR. AHMED YOUSIF ABDELMAGID M.D.
Individual
Emergency Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-3151
1467401380CRANE EMERGENCY PHYSICIANS
Organization
Emergency Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-3151
1245283357DR. DENNIS PETER SORRESSO M.D.
Individual
Internal Medicine (Sleep Medicine)159 N 3RD ST
MACCLENNY, FL 32063
(904) 465-3183
1952322125DR. PAUL JARCZYK MD
Individual
Emergency Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-3151
1942480850DEL MEDICAL ASSOCIATES INC
Organization
Internal Medicine (Sleep Medicine)159 N 3RD ST
MACCLENNY, FL 32063
(904) 465-3183
1366628679JOHN J COLEMAN DPM
Organization
Podiatrist159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-5277
1619137874BAKER EMERGENCY GROUP LLC
Organization
Emergency Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-3151
1346494556PETER C. JANSEN MD
Organization
Family Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-7815
1174761613BAKER COUNTY HOSPITAL AUTHORITY
Organization
Skilled Nursing Facility159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-3151
1255630554WESTLAKE EMERGENCY MEDICAL ASSOCIATES & CONSULTANTS, LLC
Organization
Emergency Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-3151
1922026061DR. PATRICIA F WHITE DO
Individual
Emergency Medicine159 N 3RD ST ED FRASER MEMORIAL HOSPITAL
MACCLENNY, FL 32063
(904) 259-3151
1922372788 KYLE MONROE KNABB DO
Individual
Internal Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-7815
1730287152DR. PATRICIA A. JONES MD
Individual
Family Medicine159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-7815
1831594977BAKER COUNTY MEDICAL SERVICES INC.
Organization
Skilled Nursing Facility159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-3151
1023423829 MARCHETA CREWS ARNP
Individual
Nurse Practitioner (Family)159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-3151
1902257223 KERIE-ANN LAWRENCE ARNP
Individual
Nurse Practitioner (Women's Health)159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-3151
1992753016 JOSEPH JULIAN LOPEZ MD
Individual
Internal Medicine (Gastroenterology)159 N 3RD ST
MACCLENNY, FL 32063
(904) 259-3151

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.