Deborah Fralicker, DC
Individual provider Active NPI Family Nurse Practitioner · Jacksonville, FL
NPI 1174569693 · NPPES record last updated Apr 7, 2017
Key facts
- NPI
- 1174569693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- ARNP770742 (FL)
- Practice address
- 12620 Beach Blvd
Suite 6
Jacksonville, FL 32246-7131 - Phone
- (904) 645-0777
- Fax
- (904) 645-3483
- NPI assigned
- Jun 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fleming Island Family Chiropractic
Practice addresses (Care Compare)
1835 Eastwest Pkwy
Suite 3
Fleming Island, FL 32003-5310
Phone (904) 264-3770
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130827000338 | FL | Practitioner - Nurse Practitioner | 9931144128 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH 4435 | FL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fleming Island Family Chiropractic | Chiropractor | Current |
Accepting new patients |
| Musa Chiropractic & Wellness Center Inc | Chiropractor | Current |
Accepting new patients |
| Mark Pierce Chiropractic Clinic | Chiropractor | Past | Accepting new patients |
| Southeastern Neuroscience Institute PA | Past | Accepting new patients |
Locations
1915 Eastwest Pkwy
Ste 2
Orange Park, FL 32003
Phone (904) 269-1799
1835 Eastwest Pkwy
Ste 3
Orange Park, FL 32003
Phone (904) 264-3770
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH 4435 | FL | |
| Family Nurse Practitioner | 363LF0000X | ARNP770742 | FL | Yes |
Addresses
Primary practice location
12620 Beach Blvd
Suite 6
Jacksonville, FL 32246-7131
Mailing address
835 Cesery Blvd
Jacksonville, FL 32211-5605
Phone (904) 745-1444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 380447000 | Medicaid | FL |
Other providers in Jacksonville, FL
- Eileen Lisett Fragoso Perez
- Paul R Fraley
- Jennifer Lynn Fralick
- Fralicker Chiropractic Clinic Inc.
- Albert William Fralicker
- Michael Stanley Frame
- Brian Frampton
- Ivana Alexandra Frampton
- Fran Cuchiara, Inc.
- Fran Tanner LLC
All providers in Jacksonville, FL · Family Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 7, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.