Individual provider Active NPI

Christa Gant, NP-C

  • Family Nurse Practitioner
  • Jeffersontown, KY
National Provider Identifier
1013316934
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3008980 Issued in KY
Practice address
10823 Bluegrass Pkwy
Jeffersontown, KY 40299-2215
Phone
(502) 901-1136
Fax
(502) 237-6820
NPI assigned
Aug 15, 2014
Last updated
Sep 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71005060A IN
Family Nurse Practitioner 363LF0000X 3008980 KY Primary

Addresses

Primary practice location

10823 Bluegrass Pkwy
Jeffersontown, KY 40299-2215

Mailing address

10823 Bluegrass Pkwy
Jeffersontown, KY 40299-2215
Phone (502) 901-1136

Other identifiers 1

IdentifierTypeStateIssuer
201253430MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241012000366 KY Order and Referring Only - Nurse Practitioner 0749401834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71005060AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Strong Roots Health Center Family CurrentSince Sep 29, 2024 Accepting new patients

Locations

10823 Bluegrass Pkwy
Jeffersontown, KY 40299
Phone (502) 901-1136

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24215/brand/1/csg/1/fhir/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1013316934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10823 BLUEGRASS PKWY",
            "city": "JEFFERSONTOWN",
            "state": "KY",
            "postal_code": "402992215",
            "telephone_number": "502-901-1136",
            "fax_number": "502-237-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10823 BLUEGRASS PKWY",
            "city": "JEFFERSONTOWN",
            "state": "KY",
            "postal_code": "402992215",
            "telephone_number": "502-901-1136",
            "fax_number": "502-237-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANT",
        "first_name": "CHRISTA",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-15",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71005060A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201253430",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersontown, KY

Sources for this page

Verify at the official NPI Registry.