Individual provider Active NPI

Chrisjonna Foster, APRN

  • Family Nurse Practitioner
  • Winter Haven, FL
National Provider Identifier
1669216404
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11033602 Issued in FL
Practice address
1450 6TH St SE
Winter Haven, FL 33880-4505
Phone
(863) 293-2147
Fax
(863) 294-2767
NPI assigned
Jun 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11033602 FL Primary

Addresses

Primary practice location

1450 6TH St SE
Winter Haven, FL 33880-4505

Mailing address

1610 Hidden Palms Dr
Davenport, FL 33897-8410
Phone (205) 218-7173

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240627001186 FL Practitioner - Nurse Practitioner 1759825029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
K Wade Foster MD PAGroup PAC ID 3173663374, 17 clinicians

Practice addresses (Care Compare)

1450 6TH St SE
Winter Haven, FL 33880-4505
Phone (863) 293-2147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11033602FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
K Wade Foster MD PA CurrentSince Jun 25, 2024 Accepting new patients

Locations

24880 Burnt Pine Dr
Ste 1
Bonita Springs, FL 34134

3725 S US Highway 27
Ste 105
Clermont, FL 34711
Phone 8632932147 ext. 7

2508 Sand Mine Rd
#A
Davenport, FL 33897

421 Linden Ln
Lake Wales, FL 33853
Phone (863) 293-2147

9668 N US Highway 301
Wildwood, FL 34785
Phone (863) 293-2147

1450 6th St SE
Winter Haven, FL 33880
Phone (863) 293-2147

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Organizations & group practices 1

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": "1719273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1669216404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 HIDDEN PALMS DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338978410",
            "telephone_number": "205-218-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 6TH ST SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804505",
            "telephone_number": "863-293-2147",
            "fax_number": "863-294-2767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOSTER",
        "first_name": "CHRISJONNA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11033602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Haven, FL

Sources for this page

Verify at the official NPI Registry.