NPIMap

Individual provider Active NPI

Christi Lee McCleery, PA-C

  • Physician Assistant
  • Peachtree City, GA
National Provider Identifier
1780277210
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10264 Issued in GA
Practice address
529 Pinegate Rd
Peachtree City, GA 30269-1120
Phone
(786) 548-1960
NPI assigned
Feb 16, 2021
Last updated
May 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 9113854 FL
Physician Assistant 363A00000X 10264 GA Primary

Addresses

Primary practice location

529 Pinegate Rd
Peachtree City, GA 30269-1120

Mailing address

529 Pinegate Rd
Peachtree City, GA 30269-1120
Phone (786) 548-1960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20211206000500 GA Practitioner - Physician Assistant 1052701190 Reassigns benefits to 8 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9113854FLMDEmergency Medicine Physician
10264GAMDPhysician Assistant

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1780277210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 PINEGATE RD",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691120",
            "telephone_number": "786-548-1960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 PINEGATE RD",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691120",
            "telephone_number": "786-548-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLEERY",
        "first_name": "CHRISTI",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-16",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "9113854",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

Verify at the official NPI Registry.