Active NPI
Yolande Marie Eckrich, PA-C
- Physician Assistant
- Davenport, FL
National Provider Identifier
1104336783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9110800
- Practice address
- 2504 Sand Mine Rd
Davenport, FL 33897-3402 - Phone
- (863) 419-7645
- NPI assigned
- Oct 9, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9110800 | FL | Primary |
Addresses
Primary practice location
2504 Sand Mine Rd
Davenport, FL 33897-3402
Mailing address
4600 Holly Branch Dr Apt 903
Orlando, FL 32811-7117
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9110800 | FL | MD | Physician Assistant |
Interoperability endpoints
- yolande.eckrich.1@8409.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507507200000",
"number": "1104336783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4600 HOLLY BRANCH DR APT 903",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328117117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2504 SAND MINE RD",
"city": "DAVENPORT",
"state": "FL",
"postal_code": "338973402",
"telephone_number": "863-419-7645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ECKRICH",
"first_name": "YOLANDE",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-09",
"last_updated": "2017-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "9110800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.