Organization Active NPI

Christopher MD & Associates, PA

  • Family Medicine Physician
  • Crestview, FL
National Provider Identifier
1396879185
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CHRISTOPHER MD & ASSOCIATES, PA
Practice address
131 E Redstone Ave
Suite 107
Crestview, FL 32539-5326
Phone
(850) 682-6320
Fax
(850) 682-6339
NPI assigned
Mar 15, 2007
Last updated
Sep 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2022

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

Authorized official

Name
Dr. Indumathi Christopher, MDNPI 1467453613
Title
Physician
Phone
(850) 682-6320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

131 E Redstone Ave
Suite 107
Crestview, FL 32539-5326

Mailing address

131 E Redstone Ave
Suite 107
Crestview, FL 32539-5326
Phone (850) 682-6320

Other identifiers 6

IdentifierTypeStateIssuer
7689404OtherFLAETNA PROVIDER NUMBER
1431330005OtherFLCIGNA PROVIDER NUMBER
274400700MedicaidFL
2012340OtherFLFIRST HEALTH NUMBER
2236414005OtherFLUNITED HEALTHCARE NUMBER
31703OtherFLBCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060103000214 FL Part B Supplier - Clinic/Group Practice 9133141328 Receives reassigned benefits from 3 practitioners
Practice locations: Crestview, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1049356Christopher MD and Associates PA131 E Redstone Ave Ste 107, Crestview, FL 32539Certificate of waiverJan 3, 2028

National Provider Directory

National Provider Directory

Locations

131 E Redstone Ave
Ste 107
Crestview, FL 32539
Phone (850) 682-4888

601 N Pearl St
Crestview, FL 32536
Phone (850) 689-7851

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663200000000",
    "number": "1396879185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 E REDSTONE AVE",
            "address_2": "SUITE 107",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395326",
            "telephone_number": "850-682-6320",
            "fax_number": "850-682-6339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 E REDSTONE AVE",
            "address_2": "SUITE 107",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325395326",
            "telephone_number": "850-682-6320",
            "fax_number": "850-682-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTOPHER MD & ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A",
        "authorized_official_last_name": "CHRISTOPHER",
        "authorized_official_first_name": "INDUMATHI",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "850-682-6320",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "7689404",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PROVIDER NUMBER",
            "identifier": "1431330005",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274400700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NUMBER",
            "identifier": "2012340",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE NUMBER",
            "identifier": "2236414005",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "31703",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.