Christina Marie Ivy, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2018040232 Issued in MO

Practice address

2765 Red Cedar Parc Dr S
O Fallon, MO 63368-6609

Phone

(636) 248-8072

NPI assigned

Nov 12, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: christina.ivy.p2@direct.painreliefcenters.nextgenshare.com

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.

• Pophealthcare, LLC

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1164943957

  Family

  Medicare reassignment NPD
• Pophealthcare, LLC

  • Primary Care Nurse Practitioner
  • Jacksonville, FL
  • NPI 1326617150
  NPD

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

{
    "created_epoch": "1541980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541980800000",
    "number": "1104394899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2765 RED CEDAR PARC DR S",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686609",
            "telephone_number": "636-248-8072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 RED CEDAR PARC DR S",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686609",
            "telephone_number": "636-248-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-12",
        "last_updated": "2018-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018040232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Innovative Counseling Services, Inc
• Internal Medicine at Winghaven LLC
• Internal Medicine at Winghaven, LLC
• Marium Iqbal
• Iverson-Tomasino Eyecare Inc
• Daniel Jablonski, D.C.
• Jack W. Haney, D.D.S., P.C.
• Jackson Chiropractic
• Bradley C Jackson
• Brandon T. Jackson, D.C.

• Family Nurse Practitioner in O Fallon, MO
• Providers in O Fallon, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.