Individual provider Active NPI

Christine Fleury, PA

  • Physician Assistant
  • Crofton, MD
National Provider Identifier
1063507036
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
009124-1 Issued in NY
Practice address
2209 Defense Hwy
Suite C
Crofton, MD 21114-2403
Phone
(443) 332-1533
Fax
(443) 332-4271
NPI assigned
Oct 4, 2006
Last updated
Apr 5, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 009124-1 NY Primary

Addresses

Primary practice location

2209 Defense Hwy
Suite C
Crofton, MD 21114-2403

Mailing address

2209 Defense Hwy
Suite C
Crofton, MD 21114-2403
Phone (443) 332-1533

Other identifiers 4

IdentifierTypeStateIssuer
02420313MedicaidNY
000403511005OtherNYBSNENY
070418000045OtherNYFIDELIS
4151248OtherNYMVP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20110511000028 MD Practitioner - Physician Assistant 5092818286 Reassigns benefits to 1 organization
I20170523000085 DC Practitioner - Physician Assistant 5092818286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MNR Industries, LLCGroup PAC ID 7416908843, 142 clinicians

Practice addresses (Care Compare)

10416 Campus Way S
Expresscare of Largo
Largo, MD 20774-1390
Phone (301) 316-9620

1307 Merritt Blvd
Dundalk, MD 21222-2109
Phone (410) 288-2121

1354 Eastern Blvd
Expresscare of Essex
Essex, MD 21221-3423
Phone (443) 231-5203

1505 E Churchville Rd
Bel Air, MD 21014-4742

5400 Ritchie Hwy
Brooklyn, MD 21225-3443
Phone (443) 457-6694

6000 Laurel Bowie Rd
Bowie, MD 20715-4000
Phone (301) 383-0330

7566 Ridge Rd
Hanover, MD 21076-1373
Phone (410) 904-5910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
009124NYMDMental Health Counselor
9124NYMDClinical Psychologist
009124-1NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Mar 29, 2017 Accepting new patients
MNR Industries, LLC CurrentSince Sep 19, 2016 Accepting new patients
MNR Industries LLC CurrentSince Sep 19, 2016 Accepting new patients
Cedar Health Ventures, LLC Past Accepting new patients
Harcart Health Holdings LLC Past Accepting new patients
Provident Emergency Medicine Associates, PC Past Accepting new patients

Locations

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 8

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1063507036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2209 DEFENSE HWY",
            "address_2": "SUITE C",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142403",
            "telephone_number": "443-332-1533",
            "fax_number": "443-332-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2209 DEFENSE HWY",
            "address_2": "SUITE C",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142403",
            "telephone_number": "443-332-1533",
            "fax_number": "443-332-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEURY",
        "first_name": "CHRISTINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "009124-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02420313",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSNENY",
            "identifier": "000403511005",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "070418000045",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "4151248",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

Verify at the official NPI Registry.