Individual provider Active NPI

Julia Nichole Tice, APRN

  • Family Nurse Practitioner
  • Chipley, FL
National Provider Identifier
1629547641
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9497943 Issued in FL
Practice address
1338 South Blvd
Chipley, FL 32428-1846
Phone
(850) 638-6240
Fax
(850) 415-5010
NPI assigned
Nov 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9497943 FL Primary

Addresses

Primary practice location

1338 South Blvd
Chipley, FL 32428-1846

Mailing address

991 Haywood Dr
Chipley, FL 32428-2184
Phone (850) 726-0166

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
I20190604003170 FL Practitioner - Nurse Practitioner 3971836073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1338 S Blvd
Chipley, FL 32428

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9497943FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Mar 13, 2020 Accepting new patients

Locations

1338 South Blvd
Chipley, FL 32428
Phone (850) 638-6240

Organizations & group practices 1

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": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1629547641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 HAYWOOD DR",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324282184",
            "telephone_number": "850-726-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1338 SOUTH BLVD",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324281846",
            "telephone_number": "850-638-6240",
            "fax_number": "850-415-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "JULIA",
        "middle_name": "NICHOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9497943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chipley, FL

Sources for this page

Verify at the official NPI Registry.