Christa M Jeavons, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

320072 Issued in NY

Practice address

1026 Cold Springs Rd
Liverpool, NY 13088-4343

Phone

(607) 624-7132

NPI assigned

Jul 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kopa LLCGroup PAC ID 5193774461, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Kopa LLC

  • Multi-Specialty Clinic/Center
  • Orlando, FL
  • NPI 1417021114
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1245438068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1026 COLD SPRINGS RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884343",
            "telephone_number": "607-624-7132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1026 COLD SPRINGS RD",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130884343",
            "telephone_number": "607-624-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEAVONS",
        "first_name": "CHRISTA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "320072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02957413",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nickolas Izzo, PA
• Jonathan M. Jacobs, M.D.
• Kahsenniiostha Jacobs
• Jana Dosztan-Reiss, Inc.
• James Hyuk-Jae Jang, D.D.S.
• Jennifer a. Crider, LCSW, PLLC
• Jerry G. Rothrock (Liverpool Dental Center)
• Carrie Jessen
• Kathryn L Jewell, LCSW
• Joan C Laura DDS PC

• Nurse Practitioner in Liverpool, NY
• Providers in Liverpool, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.