Jaclyn Elizabeth Christie, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP026268 Issued in PA

Practice address

1215 W Baltimore Pike Ste 13
Media, PA 19063-5540

Phone

(610) 565-1919

Fax

(610) 566-8971

NPI assigned

Sep 23, 2022

Last updated

Sep 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1780307744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 W BALTIMORE PIKE STE 13",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635540",
            "telephone_number": "610-565-1919",
            "fax_number": "610-566-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 W BALTIMORE PIKE STE 13",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635540",
            "telephone_number": "610-565-1919",
            "fax_number": "610-566-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIE",
        "first_name": "JACLYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP026268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA STATE BOARD OF NURSING",
            "identifier": "SP026268",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pchristie@mediaprimarycare.medentdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1215 W Baltimore Pike Ste 13",
            "city": "Media",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190635540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Chodosh
• Jooyoung Choi
• Nadia Choudry
• Christie and Drane Family Orthodontics PC
• Elaine P Christie, O.D.
• Kimberly Christie, DMD
• Peter Nicholas Christie, D.O.
• John Darby Chrostek, DPT
• Amanda Beth Chusid, PSYD
• Olivia Ciallella

• Family Nurse Practitioner in Media, PA
• Providers in Media, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.