Individual provider Active NPI

Christine Monica Clause, ARNP

  • Pediatric Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1699766725
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
ARNP3278942 Issued in FL
Practice address
2232 Grand Ave
Fort Myers, FL 33901-3717
Phone
(239) 344-2341
Fax
(239) 334-7518
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X ARNP3278942 FL Primary

Addresses

Primary practice location

2232 Grand Ave
Fort Myers, FL 33901-3717

Mailing address

PO Box 919771
Orlando, FL 32891-9771
Phone (239) 278-3600

Other identifiers 1

IdentifierTypeStateIssuer
305961800MedicaidFL

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
I20040608001316 FL Practitioner - Nurse Practitioner 0042293326

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1699766725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919771",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919771",
            "telephone_number": "239-278-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 GRAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339013717",
            "telephone_number": "239-344-2341",
            "fax_number": "239-334-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAUSE",
        "first_name": "CHRISTINE",
        "middle_name": "MONICA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "ARNP3278942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "305961800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.