Individual provider Active NPI

Christy Ann Gonzalez, NP

  • Family Nurse Practitioner
  • Bonaire, GA
National Provider Identifier
1306293592
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN205616 Issued in GA
Practice address
127 Old Highway 96 Ste B
Bonaire, GA 31005-3461
Phone
(478) 352-7143
Fax
(478) 352-7144
NPI assigned
May 18, 2016
Last updated
Apr 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN205616 GA Primary

Addresses

Primary practice location

127 Old Highway 96 Ste B
Bonaire, GA 31005-3461

Mailing address

4300 N Point Pkwy Ste 300
Alpharetta, GA 30022-4102

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160803002584 GA Practitioner - Nurse Practitioner 4880988534 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN205616GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince May 1, 2025 Accepting new patients
Houston Primary Care Physicians, LLC CurrentSince Jul 10, 2021 Accepting new patients
Houston Primary Care Physicians LLC Current Accepting new patients
Physician First Health Network PastSince Jun 3, 2025 Accepting new patients

Locations

127 Old Highway 96
Ste B
Bonaire, GA 31005
Phone (478) 352-7143

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

2510 GA Highway 127
Kathleen, GA 31047
Phone (478) 352-7143

233 N Houston Rd
Ste 140E
Warner Robins, GA 31093
Phone (478) 975-6880

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1306293592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 N POINT PKWY STE 300",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300224102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 OLD HIGHWAY 96 STE B",
            "city": "BONAIRE",
            "state": "GA",
            "postal_code": "310053461",
            "telephone_number": "478-352-7143",
            "fax_number": "478-352-7144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CHRISTY",
        "middle_name": "ANN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN205616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonaire, GA

Sources for this page

Verify at the official NPI Registry.