Individual provider Active NPI

Christopher Dale Patterson, D.O.

  • Family Medicine Physician
  • Largo, FL
National Provider Identifier
1417947839
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS006914 Issued in FL
Practice address
12294 Indian Rocks Rd
Largo, FL 33774-3001
Phone
(727) 595-2534
Fax
(727) 595-5059
NPI assigned
Oct 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS006914 FL Primary

Addresses

Primary practice location

12294 Indian Rocks Rd
Largo, FL 33774-3001

Mailing address

12294 Indian Rocks Rd
Largo, FL 33774-3001
Phone (727) 595-2534

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100823000833 FL Practitioner - Family Practice 8820198559 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS006914FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Dade Primary Care, LLC Family Medicine CurrentSince Nov 1, 2021 Accepting new patients

Locations

12294 Indian Rocks Rd
Largo, FL 33774
Phone (727) 595-2534

1000 NW 57th Ct
Ste 400
Miami, FL 33126

14750 NW 77th Ct
Ste 100
Miami Lakes, FL 33016
Phone (786) 485-1005

3345 Burns Rd
Ste 302
Palm Beach Gardens, FL 33410
Phone (561) 622-4047

4700 N Habana Ave
Ste 403
Tampa, FL 33614
Phone (813) 876-9553

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15805/brand/1/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1417947839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12294 INDIAN ROCKS RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743001",
            "telephone_number": "727-595-2534",
            "fax_number": "727-595-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12294 INDIAN ROCKS RD",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337743001",
            "telephone_number": "727-595-2534",
            "fax_number": "727-595-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS006914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.