Individual provider Active NPI

Christina Gayle Prose, M.D.

  • Family Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1871930743
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME137610 Issued in FL
Practice address
7240 7TH PL N
West Palm Beach, FL 33411-3801
Phone
(561) 969-6663
Fax
(561) 721-3106
NPI assigned
May 31, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X BP10046757 TX
Family Medicine Physician 207Q00000X 40145 SC
Family Medicine Physician 207Q00000X ME137610 FL Primary

Addresses

Primary practice location

7240 7TH PL N
West Palm Beach, FL 33411-3801

Mailing address

7240 7TH PL N
West Palm Beach, FL 33411-3801
Phone (561) 969-6663

Other identifiers 1

IdentifierTypeStateIssuer
401452MedicaidSC

Other names 1

  • Christina Gayle Jenkins Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161114000366 SC Practitioner - Family Practice 7315226412
I20200623002843 FL Practitioner - Family Practice 7315226412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Palm Beach County Fire Fighters Health Clinic LLCGroup PAC ID 0143651679, 12 clinicians

Practice addresses (Care Compare)

7240 7TH PL N
West Palm Beach, FL 33411-3801
Phone 5619696663268

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
40145SCMDFamily Medicine Physician
BP10046757TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Palm Beach County Fire Fighters Health Clinic LLC CurrentSince May 23, 2020 Accepting new patients

Locations

7240 7th Pl N
West Palm Beach, FL 33411
Phone (561) 969-6663

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.

Hospital & facility affiliations 2

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": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1871930743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7240 7TH PL N",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334113801",
            "telephone_number": "561-969-6663",
            "fax_number": "561-721-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7240 7TH PL N",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334113801",
            "telephone_number": "561-969-6663",
            "fax_number": "561-721-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROSE",
        "first_name": "CHRISTINA",
        "middle_name": "GAYLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-31",
        "last_updated": "2023-02-24",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "BP10046757",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "40145",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME137610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401452",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "JENKINS",
            "middle_name": "GAYLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.