Christle Cuellar Guevarra, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

5101026490 Issued in MI

Practice address

9496 Rosemary LN
Brighton, MI 48114-7542

Phone

(810) 209-8882

Fax

(949) 862-8090

NPI assigned

Jun 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1427588599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9496 ROSEMARY LN",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147542",
            "telephone_number": "810-209-8882",
            "fax_number": "949-862-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9496 ROSEMARY LN",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481147542",
            "telephone_number": "810-209-8882",
            "fax_number": "949-862-8090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1524 Pinto Ln Fl 2",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891064195",
            "country_code": "US",
            "telephone_number": "702-992-6888",
            "fax_number": "702-992-6880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1260 E Woodland Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "PA",
            "postal_code": "190643956",
            "country_code": "US",
            "telephone_number": "610-690-4471",
            "fax_number": "610-690-4474",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUEVARRA",
        "first_name": "CHRISTLE",
        "middle_name": "CUELLAR",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-12",
        "last_updated": "2022-07-21",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "DO2768",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OT017953",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MI",
            "license": "5101026490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Family Medicine) Physician in Brighton, MI
• Providers in Brighton, MI by specialty
• Sports Medicine (Family Medicine) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.