Individual provider Active NPI

Justin Frye

  • Acute Care Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1750930467
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN11003590 Issued in FL
Practice address
504 N Macarthur Ave
Panama City, FL 32401-3636
Phone
(850) 769-2158
NPI assigned
Sep 5, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11003590 FL Primary

Addresses

Primary practice location

504 N Macarthur Ave
Panama City, FL 32401-3636

Mailing address

504 N Macarthur Ave
Panama City, FL 32401-3636

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
I20200117001534 FL Practitioner - Nurse Practitioner 4183059264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Richard F Walker Jr MD Nephrology Associates PAGroup PAC ID 3779672720, 9 clinicians

Practice addresses (Care Compare)

504 N Macarthur Ave
Panama City, FL 32401-3636
Phone (850) 769-2158

Hospital & facility affiliations

  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242
  • Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026
  • Jackson Hospital Hospital, Marianna, FL, CCN 100142
  • Northwest Florida Community Hospital Hospital, Chipley, FL, CCN 101308
  • Calhoun-Liberty Hospital Hospital, Blountstown, FL, CCN 101304

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates PA CurrentSince Sep 2, 2019 Accepting new patients

Locations

3048 4th St
Marianna, FL 32446
Phone (850) 526-2405

504 N MacArthur Ave
Panama City, FL 32401
Phone (850) 769-2158

17745 Ashley Dr
Panama City Beach, FL 32413

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1750930467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 N MACARTHUR AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N MACARTHUR AVE",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324013636",
            "telephone_number": "850-769-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYE",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-05",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11003590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.