NPIMap

Individual provider Active NPI

Julia Wallrich

  • Physician Assistant
  • Daytona Beach, FL
National Provider Identifier
1174339964
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9119857 Issued in FL
Practice address
1595 N Williamson Blvd
Daytona Beach, FL 32117-7214
Phone
(386) 259-6026
NPI assigned
Dec 5, 2024
Last updated
Feb 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9119857 FL Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1595 N Williamson Blvd
Daytona Beach, FL 32117-7214

Mailing address

1595 N Williamson Blvd
Daytona Beach, FL 32117-7214
Phone (386) 259-6026

Other practice location 1

6675 Corporate Center Pkwy Ste 115
Jacksonville, FL 32216-8088
Phone (904) 245-8910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250226002956 FL Practitioner - Physician Assistant 5193245702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Adventhealth Senior Care IncGroup PAC ID 7618397886, 32 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

1595 N Williamson Blvd
Daytona Beach, FL 32117-7214
Phone (386) 259-6026

900 Hope Way
Altamonte Springs, FL 32714-1502
Phone (407) 776-6130

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9119857FLMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jwallrich4157836@adventhealth.direct-ci.com

Organizations & group practices 1

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1174339964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1595 N WILLIAMSON BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177214",
            "telephone_number": "386-259-6026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 N WILLIAMSON BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177214",
            "telephone_number": "386-259-6026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6675 Corporate Center Pkwy Ste 115",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322168088",
            "country_code": "US",
            "telephone_number": "904-245-8910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLRICH",
        "first_name": "JULIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9119857",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.