Kenneth Christie, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F349282-01 Issued in NY

Practice address

78 Todt Hill Rd Ste 205
Staten Island, NY 10314-4528

Phone

(718) 691-5537

NPI assigned

May 2, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Ageless Men'S Health, Ca, PC

  • Internal Medicine Physician
  • Irvine, CA
  • NPI 1447581095
  NPD (past)

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

{
    "created_epoch": "1682985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1285323675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 RAILY CT",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121676",
            "telephone_number": "347-366-0960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 TODT HILL RD STE 205",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103144528",
            "telephone_number": "718-691-5537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIE",
        "first_name": "KENNETH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-02",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F349282-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christal D Charbonnet, DPM P.C.
• Jimmy Joseph Christi, OTR/L
• Monica Christian, FNP
• Shinny Christian, FNP
• Luanne Christiansen, M.S.P.T.
• Christina Grenoble Mental Health Counseling PLLC
• Christos D. Dossa MD PC
• William N Christy, MD
• Felisa Chruscicki Drayer, LCSW
• Christina Chrysostomou

• Family Nurse Practitioner in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; 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.