NPIMap

Individual provider Active NPI

Christina M Carnes, PA-C

  • Physician Assistant
  • Appleton, WI
National Provider Identifier
1376616417
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1536 Issued in WI
Practice address
3916 N Intertech CT
Appleton, WI 54913
Phone
(920) 996-1000
NPI assigned
Nov 16, 2006
Last updated
Jan 31, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1536 WI Primary
Medical Physician Assistant 363AM0700X 1536 WI

Addresses

Primary practice location

3916 N Intertech CT
Appleton, WI 54913

Mailing address

3916 N Intertech CT
Appleton, WI 54913-6957
Phone (920) 996-1000

Other identifiers 1

IdentifierTypeStateIssuer
41974500MedicaidWI

Other names 1

  • Christina M Jones Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041014000051 WI Practitioner - Physician Assistant 1759341746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical College of Ohio, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care Associates of Appleton, LTDGroup PAC ID 1052348612, 31 clinicians

Practice addresses (Care Compare)

3916 N Intertech CT
Appleton, WI 54913-6957
Phone (920) 996-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: cjones4810@direct.thedacare.org

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1376616417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3916 N INTERTECH CT",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549136957",
            "telephone_number": "920-996-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3916 N INTERTECH CT",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "54913",
            "telephone_number": "920-996-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNES",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-16",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1536",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1536",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41974500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "JONES",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.