Individual provider Active NPI

Christy M Chong, ARNP

  • Family Nurse Practitioner
  • St Augustine, FL
National Provider Identifier
1104271444
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9229375 Issued in FL
Practice address
1851 Old Moultrie Rd Ste a
Saint Augustine, FL 32084-4167
Phone
(904) 824-8088
Fax
(904) 826-4105
NPI assigned
Apr 24, 2016
Last updated
Nov 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9229375 FL Primary

Addresses

Primary practice location

1851 Old Moultrie Rd Ste a
Saint Augustine, FL 32084-4167

Mailing address

1851 Old Moultrie Rd Ste a
Saint Augustine, FL 32084-4167
Phone (904) 824-8088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180911001109 FL Practitioner - Nurse Practitioner 3870860018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James F Connor PAGroup PAC ID 3870563315, 4 clinicians

Practice addresses (Care Compare)

1851 Old Moultrie Rd a
Saint Augustine, FL 32084-4167
Phone (904) 824-8088

4660 13TH St
Saint Cloud, FL 34769-6765
Phone (407) 200-2300

5851 State Hwy 100 E B
Adventist Health Primary Care and Palm Coast
Palm Coast, FL 32164-2448
Phone (386) 246-8115

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9229375FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health System/Sunbelt, Inc Family CurrentSince Sep 25, 2025 Accepting new patients
Adventist Health System Sunbelt Inc Family Current Accepting new patients
Bruce H Paley PA Current Accepting new patients
James F Connor PA CurrentSince Nov 20, 2024 Accepting new patients
Paul D Jayachandra M D P a PastSince Nov 20, 2024 Accepting new patients

Locations

1851 Old Moultrie Rd
Ste A
St Augustine, FL 32084
Phone (904) 824-8088

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IBHJBA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1461456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1104271444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 OLD MOULTRIE RD STE A",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320844167",
            "telephone_number": "904-824-8088",
            "fax_number": "904-826-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 OLD MOULTRIE RD STE A",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320844167",
            "telephone_number": "904-824-8088",
            "fax_number": "904-826-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHONG",
        "first_name": "CHRISTY",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-24",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9229375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.