Active NPI
Marc Kiphonge Christie, OT
- Occupational Therapist
- Miramar, FL
National Provider Identifier
1992732036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT10020
- Practice address
- 11750 Canal St Unit 215
Miramar, FL 33025-7947 - Phone
- (954) 682-7442
- NPI assigned
- Jun 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT10020 | FL | Primary |
Addresses
Primary practice location
11750 Canal St Unit 215
Miramar, FL 33025-7947
Mailing address
11750 Canal St Unit 215
Miramar, FL 33025-7947
Phone (954) 682-7442
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OT10020 | Other | FL | OT LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT10020 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adcare Medical Center | Past | Accepting new patients | |
| Continental Health Network, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Health Maintenance Organization
- Miami, FL
- NPI 1609067990
-
- Specialist
- Miami, FL
- NPI 1962449371
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480464000000",
"number": "1992732036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11750 CANAL ST UNIT 215",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330257947",
"telephone_number": "954-682-7442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11750 CANAL ST UNIT 215",
"city": "MIRAMAR",
"state": "FL",
"postal_code": "330257947",
"telephone_number": "954-682-7442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIE",
"first_name": "MARC",
"middle_name": "KIPHONGE",
"name_prefix": "Mr.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-26",
"last_updated": "2016-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "FL",
"license": "OT10020",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OT LICENSE",
"identifier": "OT10020",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miramar, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.