Individual provider Active NPI

Christina Natale Condon

  • Family Nurse Practitioner
  • Winston-Salem, NC
National Provider Identifier
1962684514
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5004615 Issued in NC
Practice address
Medical Center Blvd
Winston-Salem, NC 27157-0001
Phone
(336) 716-2255
Fax
(336) 716-9016
NPI assigned
Dec 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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 5004615 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston-Salem, NC 27157-0001

Mailing address

PO Box 344
Winston-Salem, NC 27102-0344
Phone (336) 716-2255

Other identifiers 1

IdentifierTypeStateIssuer
7004540MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100219000508 NC Practitioner - Nurse Practitioner 4284790007 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Un of California, Irvine, College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
My Catholic Doctor PLLCGroup PAC ID 7214367101, 25 clinicians
Wake Forest University Health SciencesGroup PAC ID 4486564952, 2,633 clinicians

Practice addresses (Care Compare)

3116 Allerton Lake Dr
Winston Salem, NC 27106-4480
Phone (314) 888-5233

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

  • North Carolina Baptist Hospital Hospital, Winston-Salem, NC, CCN 340047

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5004615NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Sep 27, 2010 Accepting new patients
Minuteclinic Diagnostic of North Carolina PC Family CurrentSince Jan 15, 2010 Accepting new patients

Locations

2797 NC 55 Hwy
Cary, NC 27519
Phone (919) 362-0381

6840 Glenwood Ave
Raleigh, NC 27612
Phone (401) 770-4415

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 3

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 5

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": "1196812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1962684514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 344",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271020344",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-9016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON-SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDON",
        "first_name": "CHRISTINA",
        "middle_name": "NATALE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-05",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004540",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston-Salem, NC

Sources for this page

Verify at the official NPI Registry.