Individual provider Active NPI

Christopher Edison Villarraga, ARNP

  • Nurse Practitioner
  • Winston Salem, NC
National Provider Identifier
1710456157
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5019062 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-5754
Phone
(336) 716-6674
NPI assigned
Nov 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9361615 FL
Gerontology Nurse Practitioner 363LG0600X APRN9361615 FL
Nurse Practitioner 363L00000X 5019062 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-5754

Mailing address

Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-6674

Other practice location 1

350 7th St N
Naples, FL 34102-5754
Phone (239) 624-8250

Other identifiers 2

IdentifierTypeStateIssuer
NND5JOtherFLBCBS
105699600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181219000544 FL Practitioner - Nurse Practitioner 6406191451 Reassigns benefits to 1 organization
I20240323000000 NC Practitioner - Nurse Practitioner 6406191451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9361615FLMDNurse Practitioner
5019062NCMDNurse Practitioner
APRN9361615FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nchmd, Inc CurrentSince Mar 23, 2021 Accepting new patients
Nchmd Inc CurrentSince Mar 23, 2021 Accepting new patients
Wake Forest University Health Sciences CurrentSince Feb 1, 2024 Accepting new patients

Locations

6101 Pine Ridge Rd
#1213
Naples, FL 34119
Phone (239) 263-0849

311 Tamiami Trl N
Ste 310
Naples, FL 34102
Phone (239) 261-9990

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

1285 Creekside Blvd E
Unit 102
Naples, FL 34109
Phone (239) 624-0310

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

6101 Pine Ridge Rd
Fl 1
Naples, FL 34119
Phone (239) 263-0849

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: cvillarraga23343@nchhealthcaresystem.direct-ci.com
  • Direct secure messaging: cvillarraga2862944@carolinashealthcaresystem.direct-ci.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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1710456157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-6674",
            "fax_number": "336-716-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271575754",
            "telephone_number": "336-716-6674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 7th St N",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341025754",
            "country_code": "US",
            "telephone_number": "239-624-8250",
            "fax_number": "239-624-8251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLARRAGA",
        "first_name": "CHRISTOPHER",
        "middle_name": "EDISON",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-15",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9361615",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN9361615",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5019062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NND5J",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105699600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.