Individual provider Active NPI

Melissa Chrites

  • Internal Medicine Physician
  • Fort Walton Beach, FL
National Provider Identifier
1801216635
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO2833 Issued in NV
Practice address
1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707
Phone
(508) 863-8202
NPI assigned
Apr 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X DO2833 NV Primary

Addresses

Primary practice location

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707

Mailing address

1005 Mar Walt Dr
Fort Walton Beach, FL 32547-6707
Phone (850) 863-8202

Other practice location 1

8 Mdos
unit 2022
Apo, AP 96264
Phone (063) 470-5939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220502000464 FL Practitioner - Internal Medicine 4688996895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO2833NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White-Wilson Medical Center PA CurrentSince May 16, 2022 Accepting new patients

Locations

1005 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 863-8100

Interoperability endpoints

  • Direct secure messaging: melissa.chrites.1@15442.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1397865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1801216635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "850-863-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476707",
            "telephone_number": "508-863-8202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8 MDOS",
            "address_2": "unit 2022",
            "address_purpose": "LOCATION",
            "city": "APO",
            "state": "AP",
            "postal_code": "96264",
            "country_code": "US",
            "telephone_number": "063-470-5939",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "CHRITES",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-19",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "DO2833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.