Individual provider Active NPI

Christen R Canada, DPM

  • Foot & Ankle Surgery Podiatrist
  • Tampa, FL
National Provider Identifier
1386401024
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD305008 Issued in GA
Practice address
13000 Bruce B Downs Blvd
Tampa, FL 33612-4745
Phone
(813) 972-2000
NPI assigned
Feb 29, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD305008 GA Primary

Addresses

Primary practice location

13000 Bruce B Downs Blvd
Tampa, FL 33612-4745

Mailing address

13000 Bruce B Downs Blvd
Tampa, FL 33612-4745

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240723003118 GA Practitioner - Podiatry 9335685643 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Village Podiatry Group LLCGroup PAC ID 4587646971, 51 clinicians
Village Podiatry Group II LLCGroup PAC ID 7719218437, 70 clinicians

Practice addresses (Care Compare)

299 Country Club Dr
Stockbridge, GA 30281-7350
Phone (678) 399-2508

Hospital & facility affiliations

  • Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue26
Removal of skin lesions1-10
Removal of nail tissue64
Removal or shaving of skin growth34
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Village Podiatry Group II, LLC. CurrentSince Jan 15, 2025 Accepting new patients
Village Podiatry Group II, LLC. Foot & Ankle Surgery CurrentSince Jan 15, 2025 Accepting new patients
Village Podiatry Group LLC Foot & Ankle Surgery CurrentSince Jul 8, 2024 Accepting new patients
Village Podiatry Group, L.L.C. CurrentSince Jul 8, 2024 Accepting new patients

Locations

2045 Peachtree Rd NE
Ste 810
Atlanta, GA 30309
Phone (404) 351-0770

7279 Turner LK Rd NW
Covington, GA 30014

1240 Highway 54 W
Ste 300
Fayetteville, GA 30214

5700 Hillandale Dr
Ste 220
Lithonia, GA 30058
Phone (404) 288-4117

299 Country Club Dr
Stockbridge, GA 30281
Phone (678) 399-2508

4101 Charlotte Ave
Ste F185
Nashville, TN 37209
Phone (678) 426-2171

Interoperability endpoints

  • Direct secure messaging: christen.canada.1@4399.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1386401024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124745",
            "telephone_number": "813-972-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANADA",
        "first_name": "CHRISTEN",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD305008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.