Individual provider Active NPI

Christina Marie Maynard, APRN

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1336709906
Registry record updated Jun 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11002759 Issued in FL
Practice address
3101B W Highway 98
Panama City, FL 32401-1251
Phone
(850) 785-1419
NPI assigned
Jun 17, 2019
Last updated
Jun 17, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2019

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 11002759 FL Primary

Addresses

Primary practice location

3101B W Highway 98
Panama City, FL 32401-1251

Mailing address

3101B W Highway 98
Panama City, FL 32401-1251
Phone (850) 624-4947

Other identifiers 1

IdentifierTypeStateIssuer
11002759OtherFLWE DO NOT TAKE MEDICARE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address officemanager@sacmc.com
Other URL director@sacmc.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220704000383 FL Practitioner - Nurse Practitioner 0941680219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4015 Maynard Dr
Panama City, FL 32404-5745
Phone (850) 624-4947

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11002759FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Christina Maynard Aprn FNP-C LLC Family CurrentSince May 10, 2022 Accepting new patients

Locations

4015 Maynard Dr
Panama City, FL 32404
Phone (850) 624-4947

7940 Front Beach Rd
Panama City Beach, FL 32407

Organizations & group practices 1

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": "1560729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1336709906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101B W HIGHWAY 98",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324011251",
            "telephone_number": "850-624-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101B W HIGHWAY 98",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324011251",
            "telephone_number": "850-785-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-17",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11002759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WE DO NOT TAKE MEDICARE",
            "identifier": "11002759",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "officemanager@sacmc.com",
            "affiliation": "N",
            "address_1": "3101B W Highway 98",
            "city": "Panama City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "324011251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "director@sacmc.org",
            "affiliation": "N",
            "address_1": "3101B W Highway 98",
            "city": "Panama City",
            "state": "FL",
            "country_code": "US",
            "postal_code": "324011251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.