Christian Witherell, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

404304 Issued in NY

Practice address

19995 Soundview Ave
Southold, NY 11971-2820

Phone

(631) 335-5541

Fax

(631) 939-2006

NPI assigned

Aug 16, 2022

Last updated

Apr 15, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 NY

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stony Brook Psychiatric Associates University Faculty Practice CorporGroup PAC ID 7315836731, 101 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Christian Witherell NP in Psychiatry PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Southold, NY
  • NPI 1376314690
  Medicare reassignment NPD Authorized official
• Stony Brook Psychiatric Associates, University Faculty Practice Corpor

  • Psychiatry Physician
  • Stony Brook, NY
  • NPI 1437105905
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1144948175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19995 SOUNDVIEW AVE",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119712820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19995 SOUNDVIEW AVE",
            "city": "SOUTHOLD",
            "state": "NY",
            "postal_code": "119712820",
            "telephone_number": "631-335-5541",
            "fax_number": "631-939-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERELL",
        "first_name": "CHRISTIAN",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-16",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Tsoumpelis, OTR
• Kira Robin Verity, PTA
• Yuliya Vinnitskaya, M.D.
• Mary E Whyard, PT
• William F Buffone
• Lillian Ann Wolfe, FNP-C
• Jennifer Zaffino, LMSW

• Psychiatric/Mental Health Nurse Practitioner in Southold, NY
• Providers in Southold, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.