Individual provider Active NPI

Christina R Powell, NP-C

  • Family Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1063953016
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.015393 Issued in IL
Practice address
1401 E State St
Rockford, IL 61104-2315
Phone
(414) 290-6720
Fax
(414) 290-6755
NPI assigned
Mar 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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 209.015393 IL Primary

Addresses

Primary practice location

1401 E State St
Rockford, IL 61104-2315

Mailing address

111 E Wisconsin Ave Ste 2000
Milwaukee, WI 53202-4809
Phone (414) 290-6720

Other practice location 1

2400 N Rockton Ave
Rockford, IL 61103-3655
Phone (815) 971-2571

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
I20170411001345 IL Practitioner - Nurse Practitioner 3870879620 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rockford Emergency Physicians, LLCGroup PAC ID 4385007640, 51 clinicians
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

1401 E State St
Rockford, IL 61104-2315
Phone (779) 696-4400

5666 E State St
Rockford, IL 61108-2425
Phone (815) 226-2000

Hospital & facility affiliations

  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.015393ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP CurrentSince Oct 31, 2025 Accepting new patients
Rockford Emergency Physicians, LLC CurrentSince Aug 15, 2023 Accepting new patients
Cepamerica Illinois LLP CurrentSince Oct 31, 2025 Accepting new patients
Rockford Health Physicians CurrentSince Apr 1, 2017 Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

1401 E State St
Rockford, IL 61104
Phone (815) 489-4267

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

Organizations & group practices 5

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 1

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": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1063953016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE STE 2000",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024809",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611042315",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 N Rockton Ave",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611033655",
            "country_code": "US",
            "telephone_number": "815-971-2571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWELL",
        "first_name": "CHRISTINA",
        "middle_name": "R",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-10",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.015393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.