Active NPI
Christina Nakamoto, PA-C
- Medical Physician Assistant
- Gulfport, MS
National Provider Identifier
1770033490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA00304
- Practice address
- 4500 13TH St
Gulfport, MS 39501-2515 - Phone
- (228) 867-4000
- NPI assigned
- Oct 5, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA00304 | MS | Primary |
Addresses
Primary practice location
4500 13TH St
Gulfport, MS 39501-2515
Mailing address
4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 867-4000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00304 | MS | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481068800000",
"number": "1770033490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 13TH ST",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395012515",
"telephone_number": "228-867-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 13TH ST",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395012515",
"telephone_number": "228-867-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAKAMOTO",
"first_name": "CHRISTINA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-05",
"last_updated": "2016-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MS",
"license": "PA00304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.