Individual provider Active NPI

Courtney Carroll Frazier, ARNP

  • Family Nurse Practitioner
  • Sebastian, FL
National Provider Identifier
1194229724
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9324880 Issued in FL
Practice address
1627 US Highway 1 Ste 207
Sebastian, FL 32958
Phone
(407) 299-7333
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9324880 FL Primary

Addresses

Primary practice location

1627 US Highway 1 Ste 207
Sebastian, FL 32958

Mailing address

314 Seaside Ter
Sebastian, FL 32958-5534

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
I20180605000740 FL Practitioner - Nurse Practitioner 5991060493 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Florida Dermatology Associates P.a.Group PAC ID 1254233786, 48 clinicians

Practice addresses (Care Compare)

7652 Ashley Park CT
Suite 305
Orlando, FL 32835-6199
Phone (407) 299-7333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9324880FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Florida Dermatology Associates P.a. CurrentSince Sep 29, 2018 Accepting new patients
Neil S. Heskel, M.D. PastSince Apr 1, 2018 Accepting new patients

Locations

7652 Ashley Park Ct
Ste 305
Orlando, FL 32835
Phone (407) 839-0127

100 W Gore St
Ste 602
Orlando, FL 32806
Phone (407) 839-3999

490 Centre Lake Dr NE
Ste 201
Palm Bay, FL 32907

1627 US Highway 1
Ste 207
Sebastian, FL 32958

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1194229724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 SEASIDE TER",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329585534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 US HIGHWAY 1 STE 207",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "32958",
            "telephone_number": "407-299-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "COURTNEY",
        "middle_name": "CARROLL",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9324880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

Verify at the official NPI Registry.