Individual provider Active NPI

Christie Konen, APRN

  • Family Nurse Practitioner
  • Panama City, FL
National Provider Identifier
1992402085
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP11024348 Issued in FL
Practice address
2195 Jenks Ave Ste B
Panama City, FL 32405-4683
Phone
(850) 784-6696
Fax
(850) 785-2100
NPI assigned
Feb 9, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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 ARNP11024348 FL Primary

Addresses

Primary practice location

2195 Jenks Ave Ste B
Panama City, FL 32405-4683

Mailing address

2195 Jenks Ave Ste B
Panama City, FL 32405-4683
Phone (850) 784-6696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230228001740 FL Practitioner - Nurse Practitioner 5294108908 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dynamic Pain and Wellness LLCGroup PAC ID 8527364058, 29 clinicians
Institute of Endocrinology Diabetes Health and HormonesGroup PAC ID 8729300454, 32 clinicians

Practice addresses (Care Compare)

2110 W 23Rd St
Dynamic Pain and Wellness
Panama City, FL 32405-2369
Phone (850) 226-6801

633 E Baldwin Rd
Panama City, FL 32405-4207
Phone (850) 522-5490

Hospital & facility affiliations

  • HCA Florida Gulf Coast Hospital Hospital, Panama City, FL, CCN 100242
  • Ascension Sacred Heart Gulf Hospital, Port Saint Joe, FL, CCN 100313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP11024348FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Institute of Endocrinology Diabetes Health and Hormones CurrentSince Mar 4, 2024 Accepting new patients
Osceola Endocrine Consultants, Inc PastSince Apr 11, 2010 Accepting new patients
Azzam Adhal, M.D. PastSince Mar 20, 2023 Accepting new patients

Locations

204 W Oak St
Kissimmee, FL 34741
Phone (407) 962-4447

633 E Baldwin Rd
Panama City, FL 32405
Phone (850) 522-5490

Organizations & group practices 4

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": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1992402085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2195 JENKS AVE STE B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054683",
            "telephone_number": "850-784-6696",
            "fax_number": "850-785-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2195 JENKS AVE STE B",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054683",
            "telephone_number": "850-784-6696",
            "fax_number": "850-785-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONEN",
        "first_name": "CHRISTIE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP11024348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.