Individual provider Active NPI

Faradia Pierre, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1114538634
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME16401 Issued in FL
Practice address
2627 Riverside Ave
Jacksonville, FL 32204-4717
Phone
(904) 308-7372
NPI assigned
Aug 10, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME16401 FL Primary

Addresses

Primary practice location

2627 Riverside Ave
Jacksonville, FL 32204-4717

Mailing address

2627 Riverside Ave
Jacksonville, FL 32204-4717
Phone (904) 308-7372

Other practice location 1

120 King St
Jacksonville, FL 32204-2410
Phone (904) 760-4904

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME16401FLMDFamily Medicine Physician

Interoperability endpoints

  • Direct secure messaging: faradia.pierre.1@8967.direct.athenahealth.com
  • Direct secure messaging: faradia.pierre.1@12891.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1114538634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044717",
            "telephone_number": "904-308-7372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2627 RIVERSIDE AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044717",
            "telephone_number": "904-308-7372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 King St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322042410",
            "country_code": "US",
            "telephone_number": "904-760-4904",
            "fax_number": "904-930-4607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "FARADIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME16401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.