Individual provider Active NPI

Christine Elizabeth Tank, PA-C

  • Physician Assistant
  • White Plains, NY
National Provider Identifier
1821303488
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
005891 Issued in GA
Practice address
41 E Post Rd
White Plains, NY 10601-4699
Phone
(914) 681-2706
NPI assigned
Aug 7, 2010
Last updated
Jan 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005891 GA Primary

Addresses

Primary practice location

41 E Post Rd
White Plains, NY 10601-4699

Mailing address

1838 American Way
Lawrenceville, GA 30043-6611
Phone (770) 995-7622

Other practice location 1

5665 Peachtree Dunwoody Rd NE
Suite 200
Atlanta, GA 30342-1764
Phone (404) 252-6104

Other identifiers 1

IdentifierTypeStateIssuer
003110413BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000289 GA Practitioner - Physician Assistant 6800082850 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc CurrentSince Oct 1, 2013 Accepting new patients
The Emory Clinic Inc CurrentSince Oct 1, 2013 Accepting new patients
Peachtree Cardiovascular Surgeons at Saint Joseph's LLC Past Accepting new patients
Peachatree Cardiovascular & Thoracic Surgeons, P.a. Past Accepting new patients
Peachtree Cardiovascular & Thoracic Surgeons PA Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: ctank55605@direct.emory.org

Organizations & group practices 7

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": "1281139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1821303488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1838 AMERICAN WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300436611",
            "telephone_number": "770-995-7622",
            "fax_number": "770-995-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 E POST RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014699",
            "telephone_number": "914-681-2706"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5665 Peachtree Dunwoody Rd NE",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421764",
            "country_code": "US",
            "telephone_number": "404-252-6104",
            "fax_number": "404-257-1808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANK",
        "first_name": "CHRISTINE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-07",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003110413B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.