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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BLACK BAG MEDICAL INC
NPI 1750440988
Family Medicine in Jacksonville, FL

Active since December 06, 2006CLIA 10D1064765 · Waiver
4320 DEERWOOD LAKE PKWY, SUITE 101, PMB 321, JACKSONVILLE, FL 32216(904) 371-4051(904) 807-4839 Get Directions Write a Review

NPPES record last updated: June 24, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Black Bag Medical Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLACK BAG MEDICAL INC (NPI 1750440988) is a healthcare organization registered as a family medicine in Jacksonville, Florida and active in the NPI registry since December 2006. The organization holds a CLIA Waiver certificate valid through February 12, 2027 and lists Brian Layne Stephens, President, as its authorized official.

NPPES Registry Identity

NPI1750440988
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBLACK BAG MEDICAL INC
Location Address4320 DEERWOOD LAKE PKWY, SUITE 101, PMB 321Jacksonville, FL 32216-1177
Mailing Address4320 Deerwood Lake Pkwy Ste 101Jacksonville, FL 32216-1180 · (904) 371-4051 · Fax (904) 807-4839
Phone(904) 371-4051
Fax(904) 807-4839
Organization SubpartNo
Authorized OfficialBrian Layne StephensPresident · (904) 371-4051
Enumeration DateDecember 6, 2006
Last NPPES UpdateJune 24, 2026
NPPES CertifiedJune 24, 2026
✔ NPI 1750440988 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4320 DEERWOOD LAKE PKWY, Jacksonville, FL 32216
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1064765

Black Bag Medical Inc · Jacksonville, FL
Active · expires Feb 12, 2027
CLIA Number10D1064765
Laboratory TypePractitioner Other
Certificate Effective DateFebruary 13, 2025
Certificate Expiration DateFebruary 12, 2027
Laboratory DirectorBrian Stephens MD
Laboratory Phone(904) 371-4051
Laboratory LocationBlack Bag Medical Inc4320 Deerwood Pkwy Ste 101 Pmb 321, Jacksonville, FL 32216
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OMEGA MEDICAL INC.
Clinic/Center
4320 DEERWOOD LAKE PKWY, SUITE 719
JACKSONVILLE, FL 32216
Duval County (404) 388-6686
MS. YULANDA T FAISON- OYEBANJI DNP, NP
Nurse Practitioner (Family)
4320 DEERWOOD LAKE PKWY, 310
JACKSONVILLE, FL 32216
Duval County (904) 608-2900
AMANDA HIRSCH TAYLOR
Pharmacist
4320 DEERWOOD LAKE PKWY
JACKSONVILLE, FL 32216
Duval County (904) 620-8344
DR. CARLOS RAYMUNDO GOMEZ PHARMD
Pharmacist
4320 DEERWOOD LAKE PKWY
JACKSONVILLE, FL 32216
Duval County (904) 620-8344
SARAH MICHELLE JACKSON PHARM.D.
Pharmacist
4320 DEERWOOD LAKE PKWY
JACKSONVILLE, FL 32216
Duval County (904) 620-8344
DR. JESSICA A PETERSON PHARMD
Pharmacist
4320 DEERWOOD LAKE PKWY
JACKSONVILLE, FL 32216
Duval County (904) 620-0599
DR. GABRIELLE KATHRYN RAYMOND PHARMD, RPH
Pharmacist
4320 DEERWOOD LAKE PKWY
JACKSONVILLE, FL 32216
Duval County (904) 620-8344
JAMIE PRICE
Pharmacist
4320 DEERWOOD LAKE PKWY
JACKSONVILLE, FL 32216
Duval County (904) 620-8344

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Black Bag Medical Inc's NPI number?

The NPI number for Black Bag Medical Inc is 1750440988. It was assigned to this organization in the NPPES registry on December 6, 2006.

Where is Black Bag Medical Inc located?

Black Bag Medical Inc is located at 4320 Deerwood Lake Pkwy Suite 101, Pmb 321, Jacksonville, FL 32216. The listed phone number is (904) 371-4051.

What is Black Bag Medical Inc's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Black Bag Medical Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1064765) is associated with this NPI, valid through February 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Black Bag Medical Inc was last updated on June 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 44 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.