Individual provider Active NPI

Sarah White, APN, FNP-C

  • Family Medicine Physician
  • Morton, IL
National Provider Identifier
1073274718
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
209021278 Issued in IL
Practice address
104 E Queenwood Rd Ste 202
Morton, IL 61550-2962
Phone
(309) 621-9580
NPI assigned
Jan 5, 2022
Last updated
Jan 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 209021278 IL Primary

Addresses

Primary practice location

104 E Queenwood Rd Ste 202
Morton, IL 61550-2962

Mailing address

116 S Louisiana Ave
Morton, IL 61550-2638
Phone (309) 397-1397

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
I20221020002892 IL Practitioner - Nurse Practitioner 6901272699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

671 Cheoy Lee Cir
Winter Springs, FL 32708-5170

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209021278ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Realhealth Advanced Care SC CurrentSince Jul 8, 2022 Accepting new patients

Locations

328 W Washington St
East Peoria, IL 61611
Phone (309) 682-9000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1073274718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 S LOUISIANA AVE",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502638",
            "telephone_number": "309-397-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E QUEENWOOD RD STE 202",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502962",
            "telephone_number": "309-621-9580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SARAH",
        "credential": "APN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "209021278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

Verify at the official NPI Registry.