Individual provider Active NPI

Christina Kuebler, PA-C

  • Medical Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1154789386
Registry record updated May 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA9109230 Issued in FL
Practice address
1824 King St Ste 300
Jacksonville, FL 32204-4736
Phone
(904) 388-1820
Fax
(904) 388-1827
NPI assigned
Feb 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA9109230 FL Primary

Addresses

Primary practice location

1824 King St Ste 300
Jacksonville, FL 32204-4736

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623

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
I20171108001411 FL Practitioner - Physician Assistant 0042576084 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

1801 Barrs St
Suite 120
Jacksonville, FL 32204-4738
Phone (904) 308-2006

Hospital & facility affiliations

  • Ascension St Vincent'S Riverside Hospital, Jacksonville, FL, CCN 100040

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9109230FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Apr 28, 2019 Accepting new patients

Locations

1699 S 14th St
Ste 9
Fernandina Beach, FL 32034
Phone (904) 206-5000

1824 King St
Ste 300
Jacksonville, FL 32204
Phone (904) 381-9393

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

2 Shircliff Way
Ste 300
Jacksonville, FL 32204
Phone (904) 308-7959

4205 Belfort Rd
Ste 2069
Jacksonville, FL 32216
Phone (904) 296-0278

2 Shircliff Way
Ste 400
Jacksonville, FL 32204
Phone (904) 308-4000

1658 St Vincents Way
Ste 310
Middleburg, FL 32068
Phone (904) 308-2006

2300 Park Ave
Ste 101B
Orange Park, FL 32073
Phone (904) 249-4888

Interoperability endpoints

  • Direct secure messaging: christina.kuebler.1@8967.direct.athenahealth.com

Organizations & group practices 1

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 2

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": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559001600000",
    "number": "1154789386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 KING ST STE 300",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044736",
            "telephone_number": "904-388-1820",
            "fax_number": "904-388-1827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUEBLER",
        "first_name": "CHRISTINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2019-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9109230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.