Individual provider Active NPI

Christina M White, FNP

  • Nurse Practitioner
  • Decatur, IL
National Provider Identifier
1073123055
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2021039723 Issued in MO
Practice address
3131 N Water St
Decatur, IL 62526-2472
Phone
(217) 876-5320
Fax
(217) 876-5865
NPI assigned
Aug 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209021403 IL
Nurse Practitioner 363L00000X 2021039723 MO Primary

Addresses

Primary practice location

3131 N Water St
Decatur, IL 62526-2472

Mailing address

PO Box 3428
Springfield, IL 62708-3428
Phone (800) 577-5368

Other practice location 1

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

Other identifiers 1

IdentifierTypeStateIssuer
041454086OtherILRN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20220224001048 MO Practitioner - Nurse Practitioner 0840619243 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital SouthGroup PAC ID 8426962556, 45 clinicians
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

6420 Clayton Rd
Richmond Heights, MO 63117-1811
Phone (314) 768-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.94 of 100Reported as group
Quality
68.52
Promoting interoperability
100
Improvement activities
40
Cost
72.22

Merit-based Incentive Payment System (MIPS)

Final score
98.15 of 100Reported as apm
Quality
88.15
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2021039723MOMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC CurrentSince Aug 15, 2024 Accepting new patients
SSM Health Care Group CurrentSince Aug 1, 2023 Accepting new patients
Cep America, LLC Current Accepting new patients
SSM Health Care Group CurrentSince Aug 1, 2023 Accepting new patients
Cep America LLC CurrentSince Aug 15, 2024 Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

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

1011 Bowles Ave
Ste 425
Fenton, MO 63026
Phone (636) 326-2600

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-8222

6400 Clayton Rd
Ste 201
Saint Louis, MO 63117
Phone (314) 781-8405

1225 S Grand Blvd
#2L
Saint Louis, MO 63104
Phone (314) 977-4700

6420 Clayton Rd
Saint Louis, MO 63117
Phone (314) 768-8442

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

Interoperability endpoints

  • Direct secure messaging: cwhite1219023@directc.mercy.net

Organizations & group practices 7

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": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1073123055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "800-577-5368",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 N WATER ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262472",
            "telephone_number": "217-876-5320",
            "fax_number": "217-876-5865"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10010 Kennerly Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "314-525-1906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CHRISTINA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-05",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021403",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2021039723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "041454086",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.