Individual provider Active NPI

Karla Renee Dalrymple, PA-C

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1225219165
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9104228 Issued in FL
Practice address
836 Prudential Dr Ste 1700
Jacksonville, FL 32207-8344
Phone
(904) 398-0125
Fax
(904) 398-1832
NPI assigned
Nov 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9104228 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1700
Jacksonville, FL 32207-8344

Mailing address

PO Box 43667
Jacksonville, FL 32203-3667
Phone (904) 720-0599

Other identifiers 1

IdentifierTypeStateIssuer
009087500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090112000694 FL Practitioner - Physician Assistant 0143383588 Reassigns benefits to 1 organization
I20210525001089 GA Practitioner - Physician Assistant 0143383588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9104228FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jun 1, 2021 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Jun 1, 2021 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jun 1, 2021 Accepting new patients

Locations

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

836 Prudential Dr
Ste 1207
Jacksonville, FL 32207
Phone (904) 396-8656

836 Prudential Dr
Ste 1700
Jacksonville, FL 32207
Phone (904) 398-0125

201 Lakeshore Pt
Ste B
Saint Marys, GA 31558
Phone (912) 729-6821

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": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1225219165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43667",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322033667",
            "telephone_number": "904-720-0599",
            "fax_number": "904-376-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1700",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078344",
            "telephone_number": "904-398-0125",
            "fax_number": "904-398-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALRYMPLE",
        "first_name": "KARLA",
        "middle_name": "RENEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009087500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.