Cross-source identifiers
Every current identifier attachment, with the link method and confidence carried verbatim — deterministic links are 1.000; probabilistic links surface their real matcher confidence, never rounded up.
| Scheme | Value | Source table | Link method | Confidence | Since | Provenance |
|---|---|---|---|---|---|---|
| npi | 1104926401 | nppes_providers | deterministic_pk | 1.000 | 2026-06-10 | evidencerecorded: 2026-06-10 methodology: entity-graph/v1 evidence: {"rule":"D-NPI","source_pk":"1104926401","entity_type_code":"2"} |
| pecos_enrlmt_id | O20040210000578 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1104926401","rule":"D-PECOS","enrlmt_id":"O20040210000578"} |
| pecos_enrlmt_id | O20080528000534 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1104926401","rule":"D-PECOS","enrlmt_id":"O20080528000534"} |
| pecos_enrlmt_id | O20090306000179 | pecos_providers | exact_npi_in_pecos | 1.000 | 2026-06-16 | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 evidence: {"npi":"1104926401","rule":"D-PECOS","enrlmt_id":"O20090306000179"} |
Graph edges
One-hop relationships — ownership, chain membership, operation — each backed by a federal source row.
| Relationship | Entity | Confidence | Source table | Provenance |
|---|---|---|---|---|
| ← owns | SHERRIE RAULERSON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"09/13/2007","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"0941372668","source_pk":68120,"type_owner":"I","enrollment_id":"O20080528000534","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BAKER COUNTY MEDICAL SERVICES INC"} |
| ← owns | CHARLES KENNEDY | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"09/13/2007","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"2668579293","source_pk":68121,"type_owner":"I","enrollment_id":"O20080528000534","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BAKER COUNTY MEDICAL SERVICES INC"} |
| ← owns | CHARLES JACKSON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"01/21/2023","percentage_ownership":0} evidence: {"rule":"D-OWNER","owner_pac":"3274949557","source_pk":68122,"type_owner":"I","enrollment_id":"O20080528000534","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":0,"enrollment_organization_name":"BAKER COUNTY MEDICAL SERVICES INC"} |
| ← owns | JEFFREY CHILSON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"01/31/2024","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"4082684964","source_pk":68123,"type_owner":"I","enrollment_id":"O20080528000534","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BAKER COUNTY MEDICAL SERVICES INC"} |
| ← owns | TIFFANY VARNADOE | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"40","association_date":"06/14/2021","percentage_ownership":0} evidence: {"rule":"D-OWNER","owner_pac":"5698093136","source_pk":68125,"type_owner":"I","enrollment_id":"O20080528000534","role_code_owner":"40","role_text_owner":"CORPORATE OFFICER","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":0,"enrollment_organization_name":"BAKER COUNTY MEDICAL SERVICES INC"} |
| ← owns | BAKER COUNTY MEDICAL SERVICES INC (FL) | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"43","association_date":"09/13/2007","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6103710264","source_pk":68128,"type_owner":"O","enrollment_id":"O20080528000534","role_code_owner":"43","role_text_owner":"OPERATIONAL/MANAGERIAL CONTROL","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BAKER COUNTY MEDICAL SERVICES INC"} |
| ← owns | CHARLES WILSON | 1.000 | snf_all_owners | evidencerecorded: 2026-06-16 methodology: entity-graph/v1 attributes: {"role_code":"41","association_date":"09/13/2007","percentage_ownership":null} evidence: {"rule":"D-OWNER","owner_pac":"6305918020","source_pk":68129,"type_owner":"I","enrollment_id":"O20080528000534","role_code_owner":"41","role_text_owner":"CORPORATE DIRECTOR","dst_resolved_via":"pecos_enrlmt_id","percentage_ownership_raw":null,"enrollment_organization_name":"BAKER COUNTY MEDICAL SERVICES INC"} |
Current record
Current claims returned for this entity, grouped by provenance subject. The table exposes the source identifier recorded for each claim.
org · 1104926401 JSON
| Metric | Value | Asserted | Source |
|---|---|---|---|
| enumeration_date | 2006-09-25 | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| legal_business_name | BAKER COUNTY MEDICAL SERVICES INC | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| practice_state | FL | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
| primary_taxonomy | 282NR1301X | 2026-06-10 | Centers for Medicare & Medicaid ServicesNPPES NPI Registry (individuals) 202602 publisher: Centers for Medicare & Medicaid Services retrieved: 2026-06-10 sha256: 8b5267e250fd4df6… claim API: JSON |
Provider screening signals
NPI-keyed source families read directly for 1104926401: federal and state integrity lists, CMS Open Payments, Order and Referring eligibility, Medicare opt-out, and enrollment revalidation. Cells expose the source and provenance fields supplied by the selected record. A screening aid — re-confirm any match against the primary source before acting; absence means nothing on file in the data Fonteum currently holds, never a guarantee none exists.
Sanctions & integrity
Coverage staleExclusion coverage is stale or cannot be reconciled to an attested source artifact. This result is indeterminate and must not be treated as a clearance; check the current issuing-agency lists.
- Coverage status: indeterminate
- Screened 26 integrity lists; no negative determination was made.
14-tuple provenance (26)
Industry payments
None on file0 CMS Open Payments records on file for this NPI.
14-tuple provenance (1)
Order & referring eligibility
None on fileNo CMS Order and Referring record on file for this NPI.
14-tuple provenance (1)
Medicare opt-out
None on fileNo CMS Medicare opt-out affidavit on file for this NPI.
14-tuple provenance (1)
Revalidation
On file3 Medicare enrollment records on file.
- Earliest revalidation due: 2023-10-31
14-tuple provenance (1)
Point-in-time
Query retained claim coordinates under bitemporal-read/v1. Most facts have no superseded row; dates outside retained coverage may return no prior version, and diffs require both coordinates.
Pick a date to reconstruct, or two dates to diff. Equivalent JSON: /api/v1/history/{subject_type}/{subject_id}?at=… and …/diff?from=…&to=…