NPIMap

Individual provider Active NPI

Indumathi Christopher, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Crestview, FL
National Provider Identifier
1467453613
Registry record updated Sep 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD417048 Issued in PA
Practice address
131 E. Redstone Ave.
Suite 107
Crestview, FL 32539
Phone
(850) 682-6320
Fax
(850) 682-6339
NPI assigned
Aug 9, 2005
Last updated
Sep 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD417048 PA Primary

Addresses

Primary practice location

131 E. Redstone Ave.
Suite 107
Crestview, FL 32539

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
0019049700002MedicaidPA
274400700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060104000136 FL Practitioner - Family PracticePractitioner - Geriatric Medicine 6800878430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christopher MD and Associates PAGroup PAC ID 9133141328, 2 clinicians

Practice addresses (Care Compare)

131 E Redstone Ave
Suite 107
Crestview, FL 32539-5355
Phone (850) 682-6320

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher MD & Associates, PA CurrentSince Oct 17, 2005 Accepting new patients

Locations

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

Interoperability endpoints

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

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Aviata at Shoal CreekCrestview, FL, CCN 106028 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 5, 2023
Dec 5, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1467453613",
    "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": "32539",
            "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": "32539",
            "telephone_number": "850-682-6320",
            "fax_number": "850-682-6339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTOPHER",
        "first_name": "INDUMATHI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PA",
            "license": "MD417048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019049700002",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274400700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.