Individual provider Active NPI

Yvonne Derickson, ARNP, FNP-BC

  • Family Nurse Practitioner
  • St Augustine, FL
National Provider Identifier
1003341280
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9228240 Issued in FL
Practice address
206 Ashourian Ave Ste 209
St Augustine, FL 32092-5107
Phone
(904) 800-7246
Fax
(904) 299-4116
NPI assigned
Apr 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9228240 FL Primary

Addresses

Primary practice location

206 Ashourian Ave Ste 209
St Augustine, FL 32092-5107

Mailing address

206 Ashourian Ave Ste 209
Saint Augustine, FL 32092-5107
Phone (904) 742-2157

Other identifiers 1

IdentifierTypeStateIssuer
ME100176OtherFLLICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170614000034 FL Practitioner - Nurse Practitioner 3476789173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Institute of Pain Medicine LLCGroup PAC ID 4385769686, 38 clinicians

Practice addresses (Care Compare)

105 Whitehall Dr
Suite 115
St Augustine, FL 32086-5269
Phone (904) 800-7246

Hospital & facility affiliations

  • Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9228240FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Institute of Pain Medicine LLC CurrentSince Aug 1, 2019 Accepting new patients
Florida Institute of Pain Medicine LLC Pain Medicine CurrentSince Aug 1, 2019 Accepting new patients
Sunshine Spine and Pain PA CurrentSince May 8, 2017 Accepting new patients
Northern Florida Anesthesia Services PLLC PastSince Feb 12, 2023 Accepting new patients

Locations

4788 Hodges Blvd
Ste 105
Jacksonville, FL 32224
Phone (904) 223-6777

4796 Hodges Blvd
Ste 101
Jacksonville, FL 32224
Phone (904) 449-7246

2021 Kingsley Ave
Ste 109
Orange Park, FL 32073
Phone (904) 264-8801

105 Whitehall Dr
Ste 116
St Augustine, FL 32086
Phone (904) 719-7555

105 Whitehall Dr
Ste 115116
St Augustine, FL 32086
Phone (904) 800-7246

105 Whitehall Dr
Ste 115
St Augustine, FL 32086
Phone (904) 800-7246

206 Ashourian Ave
Ste 209
St Augustine, FL 32092
Phone (904) 800-7246

Interoperability endpoints

  • Direct secure messaging: yvonne.derickson@fpain.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CIEAED/Endpoint/CIEAED
  • FHIR API: https://fhir4.healow.com/fhir/r4/EEBACD/Endpoint/EEBACD
  • FHIR API: https://fhir4.healow.com/fhir/r4/EEBACD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1003341280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 ASHOURIAN AVE STE 209",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320925107",
            "telephone_number": "904-742-2157",
            "fax_number": "904-299-4116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 ASHOURIAN AVE STE 209",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320925107",
            "telephone_number": "904-800-7246",
            "fax_number": "904-299-4116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERICKSON",
        "first_name": "YVONNE",
        "name_prefix": "Mrs.",
        "credential": "ARNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-26",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9228240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "ME100176",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.