Individual provider Active NPI

Jarica Thigpen, PA-C

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1881094308
Registry record updated Aug 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9108134 Issued in FL
Practice address
836 Prudential Dr Ste 1700
Credentialing Department
Jacksonville, FL 32207-8344
Phone
(904) 398-0125
Fax
(904) 398-1832
NPI assigned
Sep 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2019

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 PA9108134 FL Primary

Addresses

Primary practice location

836 Prudential Dr Ste 1700
Credentialing Department
Jacksonville, FL 32207-8344

Mailing address

PO Box 40767
Credentialing Department
Jacksonville, FL 32203-0767
Phone (904) 376-3707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141203000167 FL Practitioner - Physician Assistant 7315269354 Reassigns benefits to 4 organizations
I20180910001355 GA Practitioner - Physician Assistant 7315269354 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8853GAMDOrthodontics and Dentofacial Orthopedic Dentist
PA9108134FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
FL-I Medical Services LLC CurrentSince Oct 1, 2016 Accepting new patients
FL-I Medical Services LLC CurrentSince Oct 1, 2016 Accepting new patients
Quality Primary Care P a Past Accepting new patients
Simedhealth LLC Past Accepting new patients
Guidewell Emergency Medicine Doctors, LLC PastSince Apr 6, 2025 Accepting new patients

Locations

996 Airport Rd
Destin, FL 32541
Phone (615) 338-1250

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

6500 W Newberry Rd
Gainesville, FL 32605
Phone (352) 333-4180

12311 W Newberry Rd
Newberry, FL 32669
Phone (352) 313-8000

Organizations & group practices 10

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": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565395200000",
    "number": "1881094308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40767",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322030767",
            "telephone_number": "904-376-3707",
            "fax_number": "904-391-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1700",
            "address_2": "CREDENTIALING DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078344",
            "telephone_number": "904-398-0125",
            "fax_number": "904-398-1832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIGPEN",
        "first_name": "JARICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2019-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9108134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.