MRS. JUANITA DENAE BRACY PA-C MPA ATC MED. NPI 1396855813

NPI Information

  • NPI: 1396855813
  • Provider Name: MRS. JUANITA DENAE BRACY, PA-C, MPA, ATC, MED.
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3055 COUNTY ROAD 210 W STE 110
    ST JOHNS, FL
    ZIP 32259
  • Phone: (214) 580-7277

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NPI Details

MRS. Juanita Denae Bracy, PA-C, MPA, ATC, MED. is a physician assistant in St Johns, FL. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. MRS. Juanita Denae Bracy, PA-C, MPA, ATC, MED. NPI is 1396855813. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3055 COUNTY ROAD 210 W STE 110
ST JOHNS, FL
ZIP 32259-001
Phone: (214) 580-7277

The NPI 1396855813 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 2/24/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12255A2300XSpecialist/TechnologistAthletic Trainer012000864VIRGINIANo
22255A2300XSpecialist/TechnologistAthletic TrainerCALIFORNIANo
3363AM0700XPhysician AssistantMedical306479NORTH CAROLINANo
4363AM0700XPhysician AssistantMedicalPA60497CALIFORNIANo
5363AM0700XPhysician AssistantMedicalNo
6363AM0700XPhysician AssistantMedicalPA15256TEXASNo
7363A00000XPhysician AssistantPA9118228FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10070402592OTHERCALIFORNIANATA BOC
20126000864OTHERVIRGINIAATC VIRGINIA LICENSE
3PA15256MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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