Charles Christian

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

Practice address

108 Wagner Rd
Bonifay, FL 32425-2923

Phone

(706) 681-3684

NPI assigned

Nov 10, 2022

Last updated

Nov 10, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1467160218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 BRADFORD ST APT 4",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471943",
            "telephone_number": "706-681-3684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WAGNER RD",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324252923",
            "telephone_number": "706-681-3684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "",
            "desc": "Nursing Home Administrator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "address_1": "108 Wagner Rd",
            "city": "Bonifay",
            "state": "FL",
            "country_code": "US",
            "postal_code": "324252923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nursing Home Administrator in Bonifay, FL
• Providers in Bonifay, FL by specialty
• Nursing Home Administrator in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.