JACK FLETCHER – Physical Therapist, NPI 1023849387

JACK FLETCHER is a healthcare provider. based in Jacksonville, Florida. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold a License No. 42156 (FL). The NPI Number for JACK FLETCHER is 1023849387

Main info

Male
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
JACK FLETCHER
NPI
1023849387
Phone
(904) 248-9928
Address
5732 CLIFTON AVE
Enumeration Date
9 August 2024
Last Update Date
9 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9048535106
Graduation Year
2024 (2 years ago)
PAC ID
2668904798
Group Practice PAC ID
6305063488
Professional Enrollment ID
I20241015000883
Address ID
FL322505024JA350XXSXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

4,636 PHYSICAL THERAPIST IN PRIVATE PRACTICE in FL

Provider Addresses for JACK FLETCHER

  • 5732 CLIFTON AVE

    JACKSONVILLE, FL 322116973

    Phone: (904) 248-9928

    Type: Mailing

  • 350 13TH AVE S

    JACKSONVILLE, FL 322505024

    Phone: (904) 853-5106

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241015000883IPhysical Therapist In Private PracticeFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32211)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305063488View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeFL
-FL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeAL
-FL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTN

Reviews

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Frequently asked questions

Does JACK FLETCHER share an NPI with anyone else?
NPI numbers are unique to each provider or organization — JACK FLETCHER uses 1023849387.
Does CMS list JACK FLETCHER as active?
Yes — JACK FLETCHER is active in the NPI listing used on this page.
What healthcare role does JACK FLETCHER hold?
Scheduling teams often label JACK FLETCHER under Physical Therapist. Clinical services aligned with this taxonomy classification.
Does JACK FLETCHER list a practice location?
Patients near Jacksonville, Florida may find JACK FLETCHER in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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