KATHRYN FRASER (PH.D) – Psychologist, NPI 1124128459

KATHRYN FRASER (PH.D) is a healthcare provider. based in Daytona beach, Florida. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D. They hold a License No. PY5411 (FL). The NPI Number for KATHRYN FRASER (PH.D) is 1124128459

Main info

Female
32 Years Of Experience
Accepts Medicare Assignment
Name
KATHRYN FRASER (PH.D)
NPI
1124128459
Phone
(386) 254-4165
Address
303 N CLYDE MORRIS BLVD
Enumeration Date
25 September 2006
Last Update Date
3 September 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3869474665
Graduation Year
1994 (32 years ago)
PAC ID
9830282045
Group Practice PAC ID
1254238090
Professional Enrollment ID
I20070904000675
Address ID
FL321142765DA201XXBLVD506
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,618 CLINICAL PSYCHOLOGIST in FL

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Provider Addresses for KATHRYN FRASER (PH.D)

  • Halifax Health Medical Center, 303, North Clyde Morris Boulevard, Daytona Beach, Volusia County, Florida, 32114, United States

    DAYTONA BEACH, FL 321142709

    Phone: (386) 254-4165

    Fax: (386) 254-4349

    Mailing address matches the actual address.

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: 2007-09-04

PECOS data refreshed: 2026-06-15

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
I20070904000675IClinical PsychologistFLTBD

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 32114)

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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: 1254238090View full group profile
NameSpecialtyState
O T O L A R Y N G O L O G YFL
U R O L O G YFL
Gastroenterology, Internal MedicineFL
--
-FL
-FL
-TN
Pulmonary Disease, Critical Care (Intensivists)MI
Family PracticeFL
-FL

Reviews

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Frequently asked questions

Can I cross-check KATHRYN FRASER (PH.D) using NPI 1124128459?
NPI 1124128459 belongs to KATHRYN FRASER (PH.D); compare other details if you need extra assurance.
Would KATHRYN FRASER (PH.D) appear as active to a payer?
You can treat KATHRYN FRASER (PH.D) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe KATHRYN FRASER (PH.D)'s focus?
For KATHRYN FRASER (PH.D), the primary taxonomy reads as Psychologist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for KATHRYN FRASER (PH.D)?
Travel planning: use Daytona Beach, Florida as the reference point for KATHRYN FRASER (PH.D), then confirm.
Can I trust this NPI listing for KATHRYN FRASER (PH.D)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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