Individual provider Active NPI

Kathy A. Fratrick

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1275605909
Registry record updated May 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW5602 Issued in FL
Practice address
13880 Shell Point Plaza
Suite 110
Fort Myers, FL 33908-3504
Phone
(239) 466-1111
Fax
(239) 454-2111
NPI assigned
Nov 15, 2006
Last updated
May 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW5602 FL Primary

Addresses

Primary practice location

13880 Shell Point Plaza
Suite 110
Fort Myers, FL 33908-3504

Mailing address

13880 Shell Point Plaza
Suite 110
Fort Myers, FL 33908-3504
Phone (239) 454-2146

Other practice location 1

15051 Shell Point Blvd
Fort Myers, FL 33908-1639
Phone (239) 454-2146

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.matrixcare.com/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW5602FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652054400000",
    "number": "1275605909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13880 SHELL POINT PLAZA",
            "address_2": "SUITE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083504",
            "telephone_number": "239-454-2146",
            "fax_number": "239-454-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13880 SHELL POINT PLAZA",
            "address_2": "SUITE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083504",
            "telephone_number": "239-466-1111",
            "fax_number": "239-454-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15051 Shell Point Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339081639",
            "country_code": "US",
            "telephone_number": "239-454-2146",
            "fax_number": "239-454-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRATRICK",
        "first_name": "KATHY",
        "middle_name": "A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2022-05-09",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.matrixcare.com/",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Connect URL",
            "address_1": "13880 Shell Point Plaza",
            "address_2": "Suite 110",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339083504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.