NPIMap

Individual provider Active NPI

Carroll Christopher Christie, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1023455482
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A144024 Issued in CA
Practice address
836 W Wellington Ave
Chicago, IL 60657-5147
Phone
(773) 296-5424
NPI assigned
May 25, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A144024 CA Primary

Addresses

Primary practice location

836 W Wellington Ave
Chicago, IL 60657-5147

Mailing address

836 W Wellington Ave
Chicago, IL 60657-5147
Phone (773) 296-5424

Other names 1

  • Carol Christopher Christie Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161129002347 CA Practitioner - Internal Medicine 2365746302 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Valley Medical FoundationGroup PAC ID 9830094515, 2,473 clinicians

Practice addresses (Care Compare)

800 E Washington Blvd
Crescent City, CA 95531-8359
Phone (707) 464-8511

Hospital & facility affiliations

  • Sutter Coast Hospital Hospital, Crescent City, CA, CCN 050417
  • Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
  • Curry General Hospital Hospital, Gold Beach, OR, CCN 381322
  • Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
  • Sutter Coast Hospital Inpatient rehabilitation facility, Crescent City, CA, CCN 05T417

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A144024CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Jun 1, 2023 Accepting new patients
Hospitalist Medicine Physicians of California, Inc Internal Medicine CurrentSince Oct 5, 2016 Accepting new patients
Inpatient Specialists of California, PC Internal Medicine CurrentSince Oct 15, 2022 Accepting new patients
Sutter Valley Medical Foundation Internal Medicine CurrentSince Jun 1, 2023 Accepting new patients
Sutter Coast Hospital Past Accepting new patients

Locations

18300 US Highway 18
Apple Valley, CA 92307
Phone (760) 424-2311

800 E Washington Blvd
Crescent City, CA 95531
Phone (707) 464-8511

1081 N China Lake Blvd
Ridgecrest, CA 93555
Phone (760) 446-0616

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

347 Andrieux St
Sonoma, CA 95476
Phone (707) 935-5000

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

5410 Maryland Way
Ste 100
Brentwood, TN 37027
Phone (615) 371-4431

Interoperability endpoints

  • Direct secure messaging: cchristie354210@hisp.ehr.sutterhealth.org

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Sutter Coast HospitalCrescent City, CA, CCN 050417 Hospital Corporate Director Jan 1, 2019
SCH Acute Rehab CenterCrescent City, CA, CCN 05T417 Hospital Corporate Director Jan 1, 2019
Sutter Coast Home CareCrescent City, CA, CCN 057427 Home health agency Corporate Director Jan 1, 2019

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1369440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1023455482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-296-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 W WELLINGTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575147",
            "telephone_number": "773-296-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIE",
        "first_name": "CARROLL",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-25",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A144024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "CHRISTIE",
            "middle_name": "CHRISTOPHER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.