Active NPI
Christopher Emanuel, MD
- Pediatrics Physician
- Jacksonville, FL
National Provider Identifier
1003893678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME78077
- Practice address
- 3945 San Jose Park Dr
Jacksonville, FL 32217-4612 - Phone
- (904) 731-3530
- Fax
- (904) 737-1548
- NPI assigned
- Dec 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME78077 | FL | Primary |
Addresses
Primary practice location
3945 San Jose Park Dr
Jacksonville, FL 32217-4612
Mailing address
PO Box 746638
Atlanta, GA 30374-6638
Phone (904) 202-2092
Other practice location 1
950 Marsh Landing Pkwy Ste 105A
Jacksonville Beach, FL 32250-1408
Phone (904) 280-1225
Other practice location 2
400 Colonnade Dr Ste 200
Ponte Vedra, FL 32081-6236
Phone (904) 696-7577
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME78077 | FL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Primary Care Inc | Pediatrics | Past | Accepting new patients |
| Baptist Primary Care Inc | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- cemanuel28488@baptisthealthsystemjacksonville.direct-ci.com
Organizations & group practices 2
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.
-
- Pediatrics Physician
- Jacksonville Beach, FL
- NPI 1508475815
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728518400000",
"number": "1003893678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746638",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303746638",
"telephone_number": "904-202-2092",
"fax_number": "904-376-4075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3945 SAN JOSE PARK DR",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322174612",
"telephone_number": "904-731-3530",
"fax_number": "904-737-1548"
}
],
"practiceLocations": [
{
"address_1": "950 Marsh Landing Pkwy Ste 105A",
"address_purpose": "LOCATION",
"city": "Jacksonville Beach",
"state": "FL",
"postal_code": "322501408",
"country_code": "US",
"telephone_number": "904-280-1225",
"fax_number": "904-390-7504",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "400 Colonnade Dr Ste 200",
"address_purpose": "LOCATION",
"city": "Ponte Vedra",
"state": "FL",
"postal_code": "320816236",
"country_code": "US",
"telephone_number": "904-696-7577",
"fax_number": "904-390-7513",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EMANUEL",
"first_name": "CHRISTOPHER",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-27",
"last_updated": "2024-10-10",
"certification_date": "2024-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME78077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.