Juanita Webb Fico, ARNP
Individual provider Active NPI Family Nurse Practitioner · Madison, FL
NPI 1023237302 · NPPES record last updated Dec 12, 2013
Key facts
- NPI
- 1023237302
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 80958-2 (FL)
- Practice address
- 218 SW Third Ave
Madison, FL 32340-1266 - Phone
- (850) 973-5000
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 1
Owned or controlled facilities with NPI records 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Madison County Hospital Health Systems Inc
Practice addresses (Care Compare)
224 NW Crane Ave
Madison, FL 32340-1400
Phone (850) 253-1923
Hospital & facility affiliations
- Madison County Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Madison County Memorial Hospital |
Hospital | Corporate Director | Aug 22, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151019001660 | FL | Practitioner - Nurse Practitioner | 5799094538 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 80958-2 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Department of Health | Current |
Accepting new patients | |
| Madison County Hospital Health Systems, Inc. | Current |
Accepting new patients | |
| Florida Department of Health | Current |
Accepting new patients | |
| Madison County Hospital Health Systems, Inc. | Current |
Accepting new patients |
Locations
218 SW Third Ave
Madison, FL 32340
Phone (850) 972-5000
224 NW Crane Ave
Madison, FL 32340
Phone (850) 253-1923
1255 W Washington St
Monticello, FL 32344
Phone (850) 342-0170
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/JCFEDD/Endpoint/JCFEDD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 80958-2 | FL | Yes |
Addresses
Primary practice location
218 SW Third Ave
Madison, FL 32340-1266
Mailing address
218 SW Third Ave
Madison, FL 32340-1266
Phone (850) 973-5000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 302373700 | Medicaid | FL |
Other providers in Madison, FL
- Victory Clairissa Elizabeth Evans
- Falo Hill
- Family First Wellness Clinic, LLC
- Matesha Fead
- Kenol Junior Felix
- Florida Assistant Living Organization, LLC
- Florida Assistant Living Organization, LLC
- Florida Assistant Living Organization, LLC
- Florida Department of Health
- James C Flournoy Sr.
All providers in Madison, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.