Jack Fletcher

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

42156 Issued in FL

Practice address

350 13TH Ave S
Jacksonville, FL 32250-5024

Phone

(904) 853-5106

NPI assigned

Aug 9, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coltman and Baughman Physical Therapy PAGroup PAC ID 6305063488, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Coltman and Baughman Physical Therapy PA

  • Physical Therapy Clinic/Center
  • Jacksonville Beach, FL
  • NPI 1659781300
  Medicare reassignment Care Compare group NPD
• Coltman and Baughman Physical Therapy PA

  • Physical Therapy Clinic/Center
  • Jacksonville, FL
  • NPI 1962079467
  NPD

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1023849387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5732 CLIFTON AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322116973",
            "telephone_number": "904-248-9928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 13TH AVE S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322505024",
            "telephone_number": "904-853-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JACK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "42156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Takiya Fletcher-Tillman
• Ashella Tamara Fletcher, LCSW
• Benjamin Michael Fletcher, PA-C
• Claire M Fletcher, PA-C
• Darlene Fletcher
• Kimberly Anne Fletcher, APRN
• Michael Fletcher, MD
• Morgen Rachel Fletcher, PA-C
• Fletcher's Medical Supplies, Inc.
• Fletcher's Medical Supplies, Inc. (Fletcher's Tender Care)

• Physical Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.