NPIMap

Individual provider Active NPI

Christine Michelle Tenniswood, MD

  • Family Medicine Physician
  • Pace, FL
National Provider Identifier
1841241429
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME111479 Issued in FL
Practice address
4225 Woodbine Road
Suite a
Pace, FL 32571
Phone
(850) 994-6575
Fax
(850) 994-5643
NPI assigned
May 16, 2006
Last updated
Aug 31, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0427283 KS
Family Medicine Physician 207Q00000X ME111479 FL Primary

Addresses

Primary practice location

4225 Woodbine Road
Suite a
Pace, FL 32571

Mailing address

4225 Woodbine Rd
Suite a
Pace, FL 32571-8790
Phone (850) 994-6575

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120627000345 FL Practitioner - Family Practice 9739217969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Santa Rosa Hma Physician Management, LLCGroup PAC ID 1658478532, 51 clinicians

Practice addresses (Care Compare)

4225 Woodbine Rd
Suite a
Pace, FL 32571-8791
Phone (850) 994-6575

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.8 of 100Reported as apm
Quality
77.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0427283KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Rosa Hma Physician Management LLC Family Medicine CurrentSince Jul 4, 2021 Accepting new patients
Santa Rosa Hma Physician Management, LLC Family Medicine CurrentSince May 1, 2012 Accepting new patients
Santa Rosa Hma Urgent Care LLC Past Accepting new patients
Olathe Health Physicians, Inc. Family Medicine Past Accepting new patients

Locations

4264 Avalon Blvd
Milton, FL 32583
Phone (850) 623-9654

5804 Dogwood Dr
Milton, FL 32570
Phone (850) 626-5389

7456 Navarre Pkwy
Navarre, FL 32566
Phone (850) 626-5070

4225 Woodbine Rd
Ste A
Pace, FL 32571
Phone (850) 626-2020

4225 Woodbine Rd
Ste C
Pace, FL 32571
Phone (850) 626-2020

4944 Highway 90
Pace, FL 32571
Phone (850) 994-0431

Interoperability endpoints

  • Direct secure messaging: christine.tenniswood.1@4692.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1841241429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 WOODBINE RD",
            "address_2": "SUITE A",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325718790",
            "telephone_number": "850-994-6575",
            "fax_number": "850-994-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 WOODBINE ROAD",
            "address_2": "SUITE A",
            "city": "PACE",
            "state": "FL",
            "postal_code": "32571",
            "telephone_number": "850-994-6575",
            "fax_number": "850-994-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNISWOOD",
        "first_name": "CHRISTINE",
        "middle_name": "MICHELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0427283",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME111479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pace, FL

Sources for this page

Verify at the official NPI Registry.