Individual provider Active NPI

Thomas Llewellyn Christopher, ARNP

  • Family Nurse Practitioner
  • Palatka, FL
National Provider Identifier
1144732504
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9217185 Issued in FL
Practice address
6500 Crill Ave
Palatka, FL 32177-9230
Phone
(386) 325-0575
NPI assigned
Oct 25, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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 9217185 FL Primary

Addresses

Primary practice location

6500 Crill Ave
Palatka, FL 32177-9230

Mailing address

6817 Deer Springs Rd
Keystone Heights, FL 32656-8691

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
I20210203000072 FL Practitioner - Nurse Practitioner 3375957343 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9217185FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Express Urgent Care, LLC CurrentSince Jan 1, 2021 Accepting new patients
Haven Medical Group, LLC CurrentSince Nov 9, 2022 Accepting new patients

Locations

4200 NW 90th Blvd
Gainesville, FL 32606
Phone (352) 378-2121

6500 Crill Ave
Palatka, FL 32177
Phone (386) 326-0575

6500 Crill Ave
Ste 5
Palatka, FL 32177
Phone (386) 326-0575

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1508889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508889600000",
    "number": "1144732504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6817 DEER SPRINGS RD",
            "city": "KEYSTONE HEIGHTS",
            "state": "FL",
            "postal_code": "326568691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321779230",
            "telephone_number": "386-325-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHER",
        "first_name": "THOMAS",
        "middle_name": "LLEWELLYN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-25",
        "last_updated": "2017-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9217185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

Verify at the official NPI Registry.