Individual provider Active NPI

Christopher Allan Fankboner, ARNP

  • Adult Health Nurse Practitioner
  • Longwood, FL
National Provider Identifier
1356858807
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9297304 Issued in FL
Practice address
555 W State Road 434
Longwood, FL 32750-5119
Phone
(321) 842-2994
Fax
(407) 767-5801
NPI assigned
Jan 5, 2018
Last updated
Feb 13, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X ARNP9297304 FL Primary
Family Nurse Practitioner 363LF0000X 9297304 FL

Addresses

Primary practice location

555 W State Road 434
Longwood, FL 32750-5119

Mailing address

555 W State Road 434
Longwood, FL 32750-5119
Phone (321) 842-2994

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
I20180315000881 FL Practitioner - Nurse Practitioner 8729340575 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Guidewell Emergency Medicine Doctors, LLCGroup PAC ID 8224352919, 88 clinicians

Practice addresses (Care Compare)

113 N Orlando Ave
Winter Park, FL 32789-3675
Phone (407) 801-8400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9297304FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Guidewell Emergency Medicine Doctors, LLC CurrentSince Sep 25, 2018 Accepting new patients
Guidewell Emergency Medicine Doctors, LLC CurrentSince Apr 6, 2025 Accepting new patients

Locations

113 N Orlando Ave
Winter Park, FL 32789
Phone (407) 801-8400

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1515110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1356858807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505119",
            "telephone_number": "321-842-2994",
            "fax_number": "407-767-5801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505119",
            "telephone_number": "321-842-2994",
            "fax_number": "407-767-5801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANKBONER",
        "first_name": "CHRISTOPHER",
        "middle_name": "ALLAN",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-05",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9297304",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9297304",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.