Individual provider Active NPI

Christopher Myers, NP

  • Family Nurse Practitioner
  • Wilmington, DE
National Provider Identifier
1417979618
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
LG-0000262 Issued in DE
Practice address
213 Greenhill Ave Ste B
Wilmington, DE 19805-1844
Phone
(302) 429-5870
Fax
(302) 429-9284
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 26NN05967300 NJ
Family Nurse Practitioner 363LF0000X LG-0000262 DE Primary

Addresses

Primary practice location

213 Greenhill Ave Ste B
Wilmington, DE 19805-1844

Mailing address

210 Leonard Ave
Clarksboro, NJ 08020-1502
Phone (302) 429-5870

Other identifiers 1

IdentifierTypeStateIssuer
0033367MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20040730000358 NJ Practitioner - Nurse Practitioner 2264402791 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
LG-0000262DEMDFamily Nurse Practitioner
26NN05967300NJMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care, Inc. CurrentSince Feb 18, 2017 Accepting new patients
Community Health Care, Inc. CurrentSince Feb 18, 2017 Accepting new patients
Family Medicine at Greenhill Past Accepting new patients
South Cumberland Medical Associates PC PastSince Jun 20, 2022 Accepting new patients

Locations

30 N Pearl St
Bridgeton, NJ 08302

335 Delsea Dr N
Glassboro, NJ 08028
Phone (856) 863-5720

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453334400000",
    "number": "1417979618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LEONARD AVE",
            "city": "CLARKSBORO",
            "state": "NJ",
            "postal_code": "080201502",
            "telephone_number": "302-429-5870",
            "fax_number": "302-429-9284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 GREENHILL AVE STE B",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198051844",
            "telephone_number": "302-429-5870",
            "fax_number": "302-429-9284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "CHRISTOPHER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2016-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NN05967300",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0000262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0033367",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, DE

Sources for this page

Verify at the official NPI Registry.