Individual provider Active NPI

Christina Marie Weibley, FNP-C, FPA

  • Family Nurse Practitioner
  • Salem, IL
National Provider Identifier
1043941123
Registry record updated Jun 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277.004549 Issued in IL
Practice address
207 E Main St
Salem, IL 62881-2926
Phone
(618) 740-2240
Fax
(618) 740-2241
NPI assigned
Jun 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2026

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 277.004549 IL Primary

Addresses

Primary practice location

207 E Main St
Salem, IL 62881-2926

Mailing address

207 E Main St
Salem, IL 62881-2926
Phone (618) 740-2240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230926000595 IL Practitioner - Nurse Practitioner 8123403011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Heartland Women's Healthcare LTDGroup PAC ID 1759270648, 29 clinicians
Revival Health and Wellness ClinicGroup PAC ID 5496246563, 2 clinicians

Practice addresses (Care Compare)

1170 Fortune Blvd
Shiloh, IL 62269-7358
Phone (618) 997-5266

207 E Main St
Salem, IL 62881-2926
Phone (618) 740-2240

Merit-based Incentive Payment System (MIPS)

Final score
82.36 of 100Reported as group
Quality
84.63
Improvement activities
40
Cost
55.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277.004549ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Heartland Women's Healthcare LTD CurrentSince Aug 10, 2023 Accepting new patients
Heartland Women's Healthcare LTD CurrentSince Aug 10, 2023 Accepting new patients
Revival Health and Wellness Clinic CurrentSince Mar 15, 2026 Accepting new patients
Heartland Women's Healthcare Il PC Past Accepting new patients

Locations

900 E Walnut St
Ste 10
Carbondale, IL 62901

3408 Office Park Dr
Marion, IL 62959
Phone 6189975266 ext. 176

3230 Veterans Memorial Dr
Mount Vernon, IL 62864

207 E Main St
Salem, IL 62881
Phone (618) 740-2240

1197 Fortune Blvd
Shiloh, IL 62269

1197 Fortune Blvd
Ste 1
Shiloh, IL 62269
Phone (877) 456-2496

1170 Fortune Blvd
Shiloh, IL 62269
Phone (205) 246-5690

6 Park Pl
Swansea, IL 62226
Phone (618) 233-0522

Interoperability endpoints

  • Direct secure messaging: christina.weibley.1@21608.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1043941123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 E MAIN ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628812926",
            "telephone_number": "618-740-2240",
            "fax_number": "618-740-2241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E MAIN ST",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628812926",
            "telephone_number": "618-740-2240",
            "fax_number": "618-740-2241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIBLEY",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "FNP-C, FPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277.004549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IL

Sources for this page

Verify at the official NPI Registry.