Vanicki Westbrook, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9116939 Issued in FL

Practice address

2233 Park Avenue
Suite 403 & 405
Orange Park, FL 32073-5569

Phone

(904) 688-3000

Fax

(904) 688-3001

NPI assigned

Sep 25, 2021

Last updated

Jan 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Vanicki Fleming-Harrell Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vanicki.westbrook.1@12891.direct.athenahealth.com

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.

• Agape Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1962867762
  Medicare reassignment
• Trenton Medical Center Inc

  dba Palms Medical Group

  • Federally Qualified Health Center (FQHC)
  • Trenton, FL
  • NPI 1801826268
  Medicare reassignment
• Agape Community Health Center, Inc

  dba Agape Community Health Center, Inc- University

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1245695774
  NPD
• Agape Community Health Center, Inc.

  dba Wesconnett Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1578928826
  NPD
• Trenton Medical Center, Inc.

  dba Palms Medical Group

  • Federally Qualified Health Center (FQHC)
  • Fleming Island, FL
  • NPI 1275220238
  NPD
• Agape Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1326668351
  NPD (past)
• Agape Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, FL
  • NPI 1376178814
  NPD (past)

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

{
    "created_epoch": "1632528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1265103543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23476 NW 186TH AVE",
            "city": "HIGH SPRINGS",
            "state": "FL",
            "postal_code": "326430673",
            "telephone_number": "386-454-0698",
            "fax_number": "386-454-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 PARK AVENUE",
            "address_2": "SUITE 403 & 405",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735569",
            "telephone_number": "904-688-3000",
            "fax_number": "904-688-3001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1462 Clifton Rd NE Ste 280",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221063",
            "country_code": "US",
            "telephone_number": "404-727-7825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESTBROOK",
        "first_name": "VANICKI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-25",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANICKI",
            "last_name": "FLEMING-HARRELL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physician Assistant in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.