NPIMap

Individual provider Active NPI

Christina Cerise Johnson, ARNP

  • Nurse Practitioner
  • Crestview, FL
National Provider Identifier
1740227503
Registry record updated Feb 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9240049 Issued in FL
Practice address
302 E James Lee Blvd
Crestview, FL 32539-2827
Phone
(850) 682-1002
NPI assigned
Jun 1, 2006
Last updated
Feb 2, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9240049 FL Primary
Family Nurse Practitioner 363LF0000X 9240049 FL

Addresses

Primary practice location

302 E James Lee Blvd
Crestview, FL 32539-2827

Mailing address

12280 Lake Underhill Rd
Orlando, FL 32825-5009
Phone (850) 682-1002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060306000290 FL Practitioner - Nurse Practitioner 2860408465 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care House Calls PAGroup PAC ID 8325263270, 14 clinicians

Practice addresses (Care Compare)

2744 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-3091
Phone (850) 934-5713

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9240049FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Care House Calls PA Family CurrentSince Feb 9, 2022 Accepting new patients
Julie Staats DO Family Medicine CurrentSince Jan 1, 2020 Accepting new patients
Coastal Radiology Associates PA Past Accepting new patients

Locations

2744 Gulf Breeze Pkwy
Gulf Breeze, FL 32563
Phone (850) 313-9046

2600 Partin Dr N
Ste 120
Niceville, FL 32578
Phone (850) 279-3040

Interoperability endpoints

  • Direct secure messaging: christina.johnson.1@30358.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15113/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328140800000",
    "number": "1740227503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12280 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328255009",
            "telephone_number": "850-682-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 E JAMES LEE BLVD",
            "city": "CRESTVIEW",
            "state": "FL",
            "postal_code": "325392827",
            "telephone_number": "850-682-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTINA",
        "middle_name": "CERISE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2012-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9240049",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9240049",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview, FL

Sources for this page

Verify at the official NPI Registry.