Individual provider Active NPI

John Phillip Frazier, MSW, LCSW

  • Clinical Social Worker
  • Gainesville, FL
National Provider Identifier
1104980226
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW-128 Issued in FL
Practice address
2631 NW 41St St Ste E1
Gainesville, FL 32606-6689
Phone
(352) 804-9979
Fax
(352) 335-5359
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW-128 FL Primary

Addresses

Primary practice location

2631 NW 41St St Ste E1
Gainesville, FL 32606-6689

Mailing address

2631 NW 41St St Ste E1
Gainesville, FL 32606-6689
Phone (352) 804-9979

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040403000098 FL Practitioner - Clinical Social Worker 3274526611 Practice locations: Gainesville, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2631 NW 41St St
Gainesville, FL 32606-6689
Phone (352) 374-8526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW-128FLMDClinical Social Worker

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104980226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2631 NW 41ST ST STE E1",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066689",
            "telephone_number": "352-804-9979",
            "fax_number": "352-335-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2631 NW 41ST ST STE E1",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326066689",
            "telephone_number": "352-804-9979",
            "fax_number": "352-335-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "JOHN",
        "middle_name": "PHILLIP",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW-128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.