Individual provider Active NPI

Joann Fritsch

  • Nurse Practitioner
  • St Augustine, FL
National Provider Identifier
1033380126
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
304795 Issued in NY
Practice address
130 Health Park Blvd
St Augustine, FL 32086-5776
Phone
(904) 826-3469
Fax
(904) 808-4608
NPI assigned
Mar 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 304795 NY Primary

Addresses

Primary practice location

130 Health Park Blvd
St Augustine, FL 32086-5776

Mailing address

130 Health Park Blvd
St Augustine, FL 32086-5776
Phone (904) 826-3469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
304795NYMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1205712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1033380126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "904-826-3469",
            "fax_number": "904-808-4608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865776",
            "telephone_number": "904-826-3469",
            "fax_number": "904-808-4608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRITSCH",
        "first_name": "JOANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-17",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "304795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.