Kurt Russell Christen

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2020-03579 Issued in NC

Practice address

H M Smith Blvd
Camp Lejeune, NC 28539

Phone

(910) 451-5125

NPI assigned

Mar 6, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1710445085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575",
            "telephone_number": "910-450-3138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "H M SMITH BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "28539",
            "telephone_number": "910-451-5125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Brewster Blvd",
            "address_purpose": "LOCATION",
            "city": "Camp Lejeune",
            "state": "NC",
            "postal_code": "285472575",
            "country_code": "US",
            "telephone_number": "910-450-3138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTEN",
        "first_name": "KURT",
        "middle_name": "RUSSELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-06",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2020-03579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristopher Paul Chilcutt
• Marie Chiong
• Michael Joseph Chisam
• David Chorba, MS. ED, ATC, CSCS
• Stacy Chow, MD
• Ryan Michael Christensen, SOIDC
• John Robert Christian, PSYD
• Dominick Ciampo, SOIDC
• Cody Clark, DDS
• Hugh Clark Jr., LCSW

• Family Medicine Physician in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.