Individual provider Active NPI

Christina Leone Nordick, NP

  • Nurse Practitioner
  • Moline, IL
National Provider Identifier
1083687040
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
277001629 Issued in IL
Practice address
2200 52ND Ave
Moline, IL 61265-6308
Phone
(309) 797-2900
Fax
(309) 797-2147
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041279291 IL
Nurse Practitioner 363L00000X 209004461 IL
Nurse Practitioner 363L00000X 277001629 IL Primary

Addresses

Primary practice location

2200 52ND Ave
Moline, IL 61265-6308

Mailing address

2200 52ND Ave
Moline, IL 61265-6308
Phone (309) 797-2900

Other identifiers 1

IdentifierTypeStateIssuer
277001629OtherILFPA-APRN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041279291ILMDRegistered Nurse
209004461ILMDNurse Practitioner
277001629ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Cardiovascular Consultants,SC CurrentSince Oct 1, 2021 Accepting new patients

Locations

555 Valley View Dr
Moline, IL 61265
Phone (309) 764-9675

2200 52nd Ave
Moline, IL 61265
Phone (309) 788-7522

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1083687040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 52ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656308",
            "telephone_number": "309-797-2900",
            "fax_number": "214-730-9797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 52ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656308",
            "telephone_number": "309-797-2900",
            "fax_number": "309-797-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDICK",
        "first_name": "CHRISTINA",
        "middle_name": "LEONE",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041279291",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209004461",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277001629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FPA-APRN",
            "identifier": "277001629",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.