Individual provider Active NPI

Christina A Dea

  • Attendant Care Provider
  • Port Charlotte, FL
National Provider Identifier
1609179894
Registry record updated Dec 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Attendant Care ProviderTaxonomy code 3747A0650X
License
000523200 Issued in FL
Practice address
18117 Dickens Ave
Port Charlotte, FL 33954-1763
Phone
(941) 276-4937
NPI assigned
Dec 10, 2010
Last updated
Dec 10, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X 000523200 FL Primary

Addresses

Primary practice location

18117 Dickens Ave
Port Charlotte, FL 33954-1763

Mailing address

18117 Dickens Ave
Port Charlotte, FL 33954-1763
Phone (941) 276-4937

Other identifiers 1

IdentifierTypeStateIssuer
000523200MedicaidFL

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000523200FLMDAttendant Care Provider

NPI Registry JSON

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

{
    "created_epoch": "1291939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291939200000",
    "number": "1609179894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18117 DICKENS AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339541763",
            "telephone_number": "941-276-4937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18117 DICKENS AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339541763",
            "telephone_number": "941-276-4937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEA",
        "first_name": "CHRISTINA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-10",
        "last_updated": "2010-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": "FL",
            "license": "000523200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000523200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; 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.