Individual provider Active NPI

Christina Ann Hassert, PA-T

  • Physician Assistant
  • Jacksonville, FL
National Provider Identifier
1568811701
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAT9114966 Issued in FL
Practice address
915 W Monroe St Ste 200
Jacksonville, FL 32204-1177
Phone
(904) 384-2240
NPI assigned
Jun 8, 2016
Reactivated
Nov 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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 PAT9114966 FL Primary

Addresses

Primary practice location

915 W Monroe St Ste 200
Jacksonville, FL 32204-1177

Mailing address

915 W Monroe St Ste 200
Jacksonville, FL 32204-1177
Phone (904) 384-2240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT9114966FLMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1465344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1568811701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-384-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST STE 200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-384-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSERT",
        "first_name": "CHRISTINA",
        "middle_name": "ANN",
        "credential": "PA-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-08",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "deactivation_date": "2021-11-02",
        "reactivation_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9114966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.