Individual provider Active NPI

Christopher Lee Pheils, PA-C

  • Physician Assistant
  • Melbourne, FL
National Provider Identifier
1174574644
Registry record updated Jul 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
FLA 3053 Issued in FL
Practice address
2900 Veterans Way
Melbourne, FL 32940-8007
Phone
(321) 637-3788
Fax
(321) 637-3508
NPI assigned
May 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2007

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 FLA 3053 FL Primary

Addresses

Primary practice location

2900 Veterans Way
Melbourne, FL 32940-8007

Mailing address

2900 Veterans Way
Melbourne, FL 32940-8007
Phone (321) 637-3788

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FLA 3053FLMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1174574644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408007",
            "telephone_number": "321-637-3788",
            "fax_number": "321-637-3508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 VETERANS WAY",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329408007",
            "telephone_number": "321-637-3788",
            "fax_number": "321-637-3508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHEILS",
        "first_name": "CHRISTOPHER",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-12",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "FLA 3053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.