Chronic Pain Management Dispensary

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

ME71405 Issued in FL

Legal business name

CHRONIC PAIN MANAGEMENT DISPENSARY

Practice address

1660 Blanding Blvd
Jacksonville, FL 32210-1835

Phone

(904) 389-3800

NPI assigned

Jan 17, 2008

Organization subpart

Yes

Parent organization

PHYSICIAN'S CHOICE DISPENSING SERVICESAs reported in NPPES

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

Authorized official

Name

Ms. Cicely Eason

Title

Executive Administrator

Phone

(561) 789-4911

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1952587172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4688",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333384688",
            "telephone_number": "954-376-7313",
            "fax_number": "954-697-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 BLANDING BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322101835",
            "telephone_number": "904-389-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRONIC PAIN MANAGEMENT DISPENSARY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHYSICIAN'S CHOICE DISPENSING SERVICES",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "EASON",
        "authorized_official_first_name": "CICELY",
        "authorized_official_title_or_position": "EXECUTIVE ADMINISTRATOR",
        "authorized_official_telephone_number": "561-789-4911",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "FL",
            "license": "ME71405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany R Christopher, PA-C
• Elizabeth Christopher, MS, RD
• Erin Christopher
• Kaiyah Elaine Christopher
• Lynn Chromy, PT
• Chronius Care Medical Group PLLC
• Alexis Chrystman
• Andrew Chrystman
• Francis A Chrzanowski Jr., MD
• Brittany Rachelle Chubb

• Non-Pharmacy Dispensing Site in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.