Organization
BAPTIST AGEWELL PHYSICIANS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH TIBBS (VICE PRESIDENT)
(904) 202-3283
Entity
Organization
Contact information
Practice address
1545 S 14TH ST, FERNANDINA BEACH, FL 32034-3049
(904) 202-4243
(904) 390-7415
Mailing address
PO BOX 746636, ATLANTA, GA 30374-6636
(904) 202-2092
(904) 376-4075
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/07/2025
Last updated
03/03/2026
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up