Individual provider Active NPI

Allison M Fries, PA

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1447512397
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9106610 Issued in FL
Practice address
2700 Riverside Ave Ste 2
Jacksonville, FL 32205-8233
Phone
(904) 265-7020
Fax
(904) 621-0566
NPI assigned
Jun 15, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9106610 FL Primary

Addresses

Primary practice location

2700 Riverside Ave Ste 2
Jacksonville, FL 32205-8233

Mailing address

705 Wells Rd Ste 300
Orange Park, FL 32073-2982
Phone (904) 282-6331

Other practice location 1

3625 University Blvd S
Jacksonville, FL 32216-4222
Phone (904) 702-6111

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
I20120731000565 FL Practitioner - Physician Assistant 1658537972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Group Services PAGroup PAC ID 1254238579, 91 clinicians

Practice addresses (Care Compare)

1564 Kingsley Ave
Suite 300
Orange Park, FL 32073-4521
Phone (904) 264-8801

1811 Blanding Blvd
Suite 102
Middleburg, FL 32068-4935
Phone (904) 661-2394

1906 Southside Blvd
Jacksonville, FL 32216-1930
Phone (904) 724-3083

421 Kingsley Ave
Orange Park, FL 32073-4898

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9106610FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Group Services PA CurrentSince Jul 1, 2022 Accepting new patients
Physicians Group Services PA CurrentSince Jul 1, 2022 Accepting new patients
Kingsley Avenue Emergency Physicians LLC Past Accepting new patients
Physicians Group Services PA Past Accepting new patients

Locations

1906 Southside Blvd
Jacksonville, FL 32216
Phone (904) 724-3083

2700 Riverside Ave
Ste 2
Jacksonville, FL 32205
Phone (904) 264-8801

705 Wells Rd
#300
Orange Park, FL 32073
Phone (904) 282-5474

1564 Kingsley Ave
Ste 300
Orange Park, FL 32073
Phone (904) 264-8801

463380 State Road 200
Unit B
Yulee, FL 32097
Phone (904) 468-3080

Interoperability endpoints

  • Direct secure messaging: allison.fries.1@25110.direct.athenahealth.com

Organizations & group practices 4

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1447512397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WELLS RD STE 300",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732982",
            "telephone_number": "904-282-6331",
            "fax_number": "904-332-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 RIVERSIDE AVE STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322058233",
            "telephone_number": "904-265-7020",
            "fax_number": "904-621-0566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3625 University Blvd S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322164222",
            "country_code": "US",
            "telephone_number": "904-702-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRIES",
        "first_name": "ALLISON",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9106610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.