Individual provider Active NPI

Christina L Chambley, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1568463073
Registry record updated Feb 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA050858 Issued in PA
Practice address
8001 Roosevelt Blvd
Suite 307
Philadelphia, PA 19152-3038
Phone
(267) 731-1333
Fax
(267) 731-1284
NPI assigned
Aug 9, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA050858 PA Primary

Addresses

Primary practice location

8001 Roosevelt Blvd
Suite 307
Philadelphia, PA 19152-3038

Mailing address

151 Southhall LN
Ste 300
Maitland, FL 32751-7172
Phone (407) 875-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20050913000932 PA Practitioner - Physician Assistant 7214960061 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA050858PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pennsylvania Dermatology Partners Inc PastSince Aug 1, 2022 Accepting new patients
Andrew K Pollack Past Accepting new patients

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": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486944000000",
    "number": "1568463073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN",
            "address_2": "STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "407-875-2080",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8001 ROOSEVELT BLVD",
            "address_2": "SUITE 307",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191523038",
            "telephone_number": "267-731-1333",
            "fax_number": "267-731-1284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMBLEY",
        "first_name": "CHRISTINA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2017-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA050858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.