Individual provider Active NPI

Christopher James Stanley, M.D.

  • Gynecology Physician
  • Orlando, FL
National Provider Identifier
1629046990
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
ME72237 Issued in FL
Practice address
2501 N Orange Ave Ste 513
Orlando, FL 32804-4674
Phone
(407) 303-0410
Fax
(407) 303-0417
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X ME72237 FL Primary
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X ME72237 MN

Addresses

Primary practice location

2501 N Orange Ave Ste 513
Orlando, FL 32804-4674

Mailing address

2501 N Orange Ave Ste 513
Orlando, FL 32804-4674
Phone (407) 303-0410

Other identifiers 4

IdentifierTypeStateIssuer
4540390OtherAETNA
49301OtherFLBLUE CROSS/BLUE SHIELD
49301OtherBLUE CROSS/BLUE SHIELD
009583000MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070608000013 FL Practitioner - Obstetrics/GynecologyPractitioner - Plastic and Reconstructive Surgery 9830297217 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME72237MNMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Halifax Healthcare Systems Inc CurrentSince Mar 1, 2014 Accepting new patients

Locations

311 N Clyde Morris Blvd
Ste 360
Daytona Beach, FL 32114
Phone (386) 254-4199

311 N Clyde Morris Blvd
Ste 180
Daytona Beach, FL 32114
Phone (386) 252-4701

303 N Clyde Morris Blvd
Fl 10E
Daytona Beach, FL 32114

303 N Clyde Morris Blvd
Daytona Beach, FL 32114
Phone (386) 425-2285

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1629046990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 513",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044674",
            "telephone_number": "407-303-0410",
            "fax_number": "407-303-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 513",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044674",
            "telephone_number": "407-303-0410",
            "fax_number": "407-303-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "CHRISTOPHER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME72237",
            "primary": true
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "MN",
            "license": "ME72237",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4540390",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "49301",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "49301",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009583000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.