Individual provider Active NPI

Christina Ann Eller, DNP, RN

  • Nurse Practitioner
  • Wyoming, MI
National Provider Identifier
1053897595
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
112501 Issued in NE
Practice address
5950 Metro Way SW
Wyoming, MI 49519-9514
Phone
(616) 252-8100
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 112501 NE Primary

Addresses

Primary practice location

5950 Metro Way SW
Wyoming, MI 49519-9514

Mailing address

5950 Metro Way SW
Wyoming, MI 49519-9514
Phone (616) 252-8100

Other practice location 1

17201 Wright St Ste 200
Omaha, NE 68130-2042
Phone (402) 334-4773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20190418001228 MI Practitioner - Nurse Practitioner 8022368794 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
112501NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital CurrentSince May 1, 2019 Accepting new patients
Advantage Health Saint Mary'S Medical Group CurrentSince Sep 6, 2022 Accepting new patients
Advantage Health/Saint Mary'S Medical Group Current Accepting new patients
Advantage Health Saint Mary'S Medical Group Nurse Practitioner CurrentSince Sep 6, 2022 Accepting new patients
Metropolitan Hospital CurrentSince May 1, 2019 Accepting new patients
Mercy Health Partners Past Accepting new patients
Metropolitan Hospital Past Accepting new patients

Locations

10047 Crossroad Ct SE
Caledonia, MI 49316
Phone (616) 685-8850

250 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 685-5600

5950 Metro Way SW
Wyoming, MI 49519
Phone (616) 252-8100

5900 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 252-3243

Interoperability endpoints

  • Direct secure messaging: cwinkelman2073142@direct.trinity-health.org
  • Direct secure messaging: cwinkelman108448@direct.metrohealth.net

Organizations & group practices 8

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": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1053897595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5950 METRO WAY SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199514",
            "telephone_number": "616-252-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5950 METRO WAY SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495199514",
            "telephone_number": "616-252-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17201 Wright St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681302042",
            "country_code": "US",
            "telephone_number": "402-334-4773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLER",
        "first_name": "CHRISTINA",
        "middle_name": "ANN",
        "credential": "DNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "112501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

Verify at the official NPI Registry.