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MR. FRED CARTER EWALT PA
NPI 1487629267
Physician Assistant - Medical in Jacksonville, FL

Active since February 23, 2006
2080 CHILD ST, JACKSONVILLE, FL 32214(904) 542-7765(904) 542-7835 Get Directions Write a Review

NPPES record last updated: November 10, 2009. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Mr. Fred Carter Ewalt Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. FRED CARTER EWALT PA (NPI 1487629267) is an individual medical provider in Jacksonville, Florida, licensed in Florida (1462446) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1487629267
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. FRED CARTER EWALTCredential: PA
Location Address2080 CHILD STJacksonville, FL 32214-5005
Mailing Address2080 Child StJacksonville, FL 32214-5005 · (904) 542-7765 · Fax (904) 542-7835
Phone(904) 542-7765
Fax(904) 542-7835
Sole ProprietorNo
Enumeration DateFebruary 23, 2006
Last NPPES UpdateNovember 10, 2009
✔ NPI 1487629267 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in FL · 1462446
2080 CHILD ST, Jacksonville, FL 32214
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. STEVEN LEE UNDHEIM IDC
Military Health Care Provider (Independent Duty Corpsman)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 546-7094
RAMONA GREENE
Registered Nurse (Medical-Surgical)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-7300
DR. HANNAH GOULD MD
Military Health Care Provider
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-7762
DR. RONALD APPLEBY D.M.D
Dentist (General Practice)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-3442
MS. DEBRA LYNN WAGNER CNM, ARNP
Advanced Practice Midwife
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-7300
DR. NICOLE MARIE THATCHER MD
General Practice
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-0409
MR. ROBERT NEWTON DOBBINS III RPH
Pharmacist
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-2537
DR. DWIGHT DAVID HART PSY.D.
Psychologist (Clinical)
2080 CHILD ST
JACKSONVILLE, FL 32214
Duval County (904) 542-3473

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fred Ewalt's NPI number?

The NPI number for Fred Ewalt is 1487629267. It was assigned to this individual provider in the NPPES registry on February 23, 2006.

Where is Fred Ewalt located?

Fred Ewalt practices at 2080 Child St, Jacksonville, FL 32214. The listed phone number is (904) 542-7765.

What is Fred Ewalt's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Fred Ewalt was last updated on November 10, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.