Individual provider Active NPI

Christopher Elliott, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1700655214
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11030293 Issued in FL
Practice address
16578 N Dale Mabry Hwy
Tampa, FL 33618-1325
Phone
(813) 412-5504
NPI assigned
Dec 26, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11030293 FL Primary

Addresses

Primary practice location

16578 N Dale Mabry Hwy
Tampa, FL 33618-1325

Mailing address

16578 N Dale Mabry Hwy
Tampa, FL 33618-1325
Phone (813) 412-5504

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
I20240126002418 FL Practitioner - Nurse Practitioner 5890148787 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12015 Whitmarsh LN
Tampa, FL 33626-1737
Phone (813) 687-4870

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11030293FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC CurrentSince Apr 4, 2024 Accepting new patients
Health & Psychiatrist Consultants LLC CurrentSince Jan 1, 2024 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Apr 4, 2024 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

3919 Tampa Rd
Oldsmar, FL 34677
Phone (727) 733-6111

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

12015 Whitmarsh Ln
Tampa, FL 33626
Phone (813) 658-3600

16578 N Dale Mabry Hwy
Tampa, FL 33618
Phone (813) 412-5504

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: christopher.elliott.1@13142.direct.athenahealth.com

Organizations & group practices 3

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": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1700655214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16578 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181325",
            "telephone_number": "813-412-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16578 N DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336181325",
            "telephone_number": "813-412-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "CHRISTOPHER",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-26",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11030293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.