Christopher Tyler Staten

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

PSI46436 Issued in FL

Practice address

1394 Dunlawton Ave Apt 308
Port Orange, FL 32127-4760

Phone

(304) 962-8953

NPI assigned

Mar 24, 2025

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ty Staten Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1225830185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1394 DUNLAWTON AVE APT 308",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274760",
            "telephone_number": "304-962-8953",
            "fax_number": "304-962-8953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1394 DUNLAWTON AVE APT 308",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274760",
            "telephone_number": "304-962-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "PSI46436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TY",
            "last_name": "STATEN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Donna Starcher
• Catherine Susan Stark, RDH, ORALFACIAL MYOL
• Crystal Starkes
• Michelle Mattera Starkey
• Marcy Starling, ARNP, FNP-BC
• Kenneth Lee Staudt Jr., DDS MPH
• Steven B Staudt, DMD
• Laura Stearns, MA, CRPS
• Gregory J. Stella, M.D.
• Carl Francesco Stephens, DC

• Student in an Organized Health Care Education/Training Program in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Student in an Organized Health Care Education/Training Program in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; 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.