Individual provider Active NPI

Christian Rodriguez Cartagena, FNP-BC

  • Family Nurse Practitioner
  • Fort Campbell, KY
National Provider Identifier
1912556283
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11003977 Issued in FL
Practice address
650 Joel Dr
Fort Campbell, KY 42223-5318
Phone
(270) 798-8400
Fax
(270) 798-8224
NPI assigned
Sep 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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 APRN11003977 FL Primary

Addresses

Primary practice location

650 Joel Dr
Fort Campbell, KY 42223-5318

Mailing address

650 Joel Dr
Fort Campbell, KY 42223-5318
Phone (270) 798-8400

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20200826000891 PR Practitioner - Nurse Practitioner 0749607414 Practice locations: Caguas, PR
I20211028002557 FL Practitioner - Nurse Practitioner 0749607414 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11003977FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Physicians Network Inc CurrentSince Jan 1, 2023 Accepting new patients
Orlando Family Physicians, LLC PastSince Jan 5, 2025 Accepting new patients
Idelis Fedeslinda Arias de la Torre PastSince Jun 1, 2021 Accepting new patients
Orlando Family Physicians, LLC PastSince Sep 1, 2022 Accepting new patients
PR Pain Group LLC PastSince Nov 17, 2019 Accepting new patients

Locations

725 Rodel Cv
Ste 200
Lake Mary, FL 32746
Phone (407) 302-3119

725 Rodel Cv
Fl 2
Lake Mary, FL 32746
Phone (321) 842-4750

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

Organizations & group practices 5

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": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1912556283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400",
            "fax_number": "270-798-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8400",
            "fax_number": "270-798-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ CARTAGENA",
        "first_name": "CHRISTIAN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11003977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

Verify at the official NPI Registry.