NPIMap

Individual provider Active NPI

Christopher Luis Gomez, APRN

  • Family Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1871215723
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
280966 Issued in AZ
Practice address
77 W Forest Ave Ste 201
Flagstaff, AZ 86001-1483
Phone
(928) 773-2222
Fax
(928) 773-2598
NPI assigned
Sep 16, 2022
Last updated
Sep 16, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 280966 AZ Primary

Addresses

Primary practice location

77 W Forest Ave Ste 201
Flagstaff, AZ 86001-1483

Mailing address

401 N Bertrand St
Flagstaff, AZ 86001-4702
Phone (928) 380-1439

Other names 1

  • Mr. Christopher Luis Gomez Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20221017002226 AZ Practitioner - Nurse Practitioner 7911373949 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Flagstaff Surgical Associates PAGroup PAC ID 6901880210, 32 clinicians

Practice addresses (Care Compare)

77 W Forest Ave
Suite 201
Flagstaff, AZ 86001-1483
Phone (928) 773-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
280966AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flagstaff Surgical Associates PA CurrentSince Sep 27, 2022 Accepting new patients

Locations

1200 N Beaver St
Flagstaff, AZ 86001
Phone (928) 213-6235

77 W Forest Ave
Ste 201
Flagstaff, AZ 86001
Phone (928) 773-2222

77 W Forest Ave
Ste 305
Flagstaff, AZ 86001
Phone (480) 229-8068

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BJDHBD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1871215723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N BERTRAND ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014702",
            "telephone_number": "928-380-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE STE 201",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011483",
            "telephone_number": "928-773-2222",
            "fax_number": "928-773-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "CHRISTOPHER",
        "middle_name": "LUIS",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "280966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTOPHER",
            "last_name": "GOMEZ",
            "middle_name": "LUIS",
            "prefix": "MR.",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.