Chris Dimitrios Idaris, CPNP-AC

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

11025159 Issued in FL

Practice address

501 6TH Ave S
St Petersburg, FL 33701-4634

Phone

(727) 767-3333

NPI assigned

Mar 15, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: cidaris867018@direct.hopkinsmedicine.org

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1104527290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 DADE AVE APT 2523",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044708",
            "telephone_number": "978-602-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 6TH AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014634",
            "telephone_number": "727-767-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IDARIS",
        "first_name": "CHRIS",
        "middle_name": "DIMITRIOS",
        "credential": "CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "FL",
            "license": "11025159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scheber Ibreus
• Icare Homecare LLC
• Elisa Rosario Icaza, ARNP
• Suzanne T Icely, M.D.
• Icm Associates, Inc.
• Idongesit Silas Idiong, PHARM.D
• Malaz Idris
• Patricia Igar, CSCS, LMT, RYT
• Adetoluwa Emmanuel Ijidakinro, MD
• Ramona Nicoleta Ilie, MD

• Critical Care Pediatric Nurse Practitioner in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Critical Care Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.