Individual provider Active NPI

Deborah Fralicker, DC

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1174569693
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP770742 Issued in 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
Last updated
Apr 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP770742 FL Primary
Chiropractor 111N00000X CH 4435 FL

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 1

IdentifierTypeStateIssuer
380447000MedicaidFL

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130827000338 FL Practitioner - Nurse Practitioner 9931144128 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fleming Island Family ChiropracticGroup PAC ID 0749382190, 2 clinicians

Practice addresses (Care Compare)

1835 Eastwest Pkwy
Suite 3
Fleming Island, FL 32003-5310
Phone (904) 264-3770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH 4435FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fleming Island Family Chiropractic Chiropractor CurrentSince Aug 3, 2020 Accepting new patients
Musa Chiropractic & Wellness Center Inc Chiropractor CurrentSince Mar 31, 2018 Accepting new patients
Mark Pierce Chiropractic Clinic Chiropractor Past Accepting new patients
Southeastern Neuroscience Institute PA Past Accepting new patients

Locations

1835 Eastwest Pkwy
Ste 3
Orange Park, FL 32003
Phone (904) 264-3770

1915 Eastwest Pkwy
Ste 2
Orange Park, FL 32003
Phone (904) 269-1799

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1174569693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 CESERY BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322115605",
            "telephone_number": "904-745-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12620 BEACH BLVD",
            "address_2": "SUITE 6",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322467131",
            "telephone_number": "904-645-0777",
            "fax_number": "904-645-3483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALICKER",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP770742",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 4435",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380447000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.