Cristina Evans Brehob, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

8685 Issued in GA

Practice address

119 Harmony Xing Ste 3
Eatonton, GA 31024-9571

Phone

(706) 485-4004

Fax

(706) 262-2986

NPI assigned

Mar 23, 2011

Last updated

Jul 27, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

Other names 1

• Cristina Ann Evans Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1932408440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 HARMONY XING STE 3",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310249571",
            "telephone_number": "706-485-4004",
            "fax_number": "706-262-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 HARMONY XING STE 3",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310249571",
            "telephone_number": "706-485-4004",
            "fax_number": "706-262-2986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 20th St S",
            "address_2": "Depart of Neurosurgery 1046 Faculty Office Tower",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352943410",
            "country_code": "US",
            "telephone_number": "205-934-7170",
            "fax_number": "205-975-5125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 Harmony Xing Ste 1",
            "address_purpose": "LOCATION",
            "city": "Eatonton",
            "state": "GA",
            "postal_code": "310249548",
            "country_code": "US",
            "telephone_number": "706-485-4004",
            "fax_number": "706-262-2986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREHOB",
        "first_name": "CRISTINA",
        "middle_name": "EVANS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-23",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22787",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.751",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "8685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051115879",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "128044",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127989",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051115881",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08300026",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTINA",
            "last_name": "EVANS",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Medical Physician Assistant in Eatonton, GA
• Providers in Eatonton, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.