Jacqueline Frazer, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

11010652 Issued in FL

Practice address

3040 E College Ave
Ruskin, FL 33570-5220

Phone

(813) 331-3940

NPI assigned

May 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Jackie Filides 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

Specialty

Nurse Practitioner

Education

Creighton University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sun City Center Health and Wellness LLCGroup PAC ID 1052531894, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Sun City Center Health and Wellness LLC

  • General Practice Physician
  • Ruskin, FL
  • NPI 1871992545
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1589587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1326660978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 SONG SPARROW CT",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335708007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 E COLLEGE AVE",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335705220",
            "telephone_number": "813-331-3940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZER",
        "first_name": "JACQUELINE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-16",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "FL",
            "license": "RN9304259",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "FL",
            "license": "646848",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11010652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "FILIDES",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Florida Cancer Physicians Network LLC
• Florida Medical Clinic, LLC
• Wendy Florvil- Sinclair
• Fountain of Peace LLC
• Brandon Frampton
• Zachary Freeman, OT
• Fresenius Medical Care Apollo Beach, LLC
• Froug Sun City Dental Center
• Fruition Home Care
• Melissa Anne Fuentes Sweet, APRN

• Nurse Practitioner in Ruskin, FL
• Providers in Ruskin, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.