Individual provider Active NPI

Christina A Small, CRNP

  • Family Nurse Practitioner
  • Media, PA
National Provider Identifier
1154588648
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP009567 Issued in PA
Practice address
1088 W Baltimore Pike
Suite 2104
Media, PA 19063-5146
Phone
(610) 744-2980
Fax
(610) 744-2982
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP009567 PA Primary

Addresses

Primary practice location

1088 W Baltimore Pike
Suite 2104
Media, PA 19063-5146

Mailing address

1088 W Baltimore Pike
Suite 2104
Media, PA 19063-5146
Phone (610) 744-2980

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100806000473 PA Practitioner - Nurse Practitioner 1850462086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Infectious Diseases Medical Associates LLCGroup PAC ID 3173691649, 5 clinicians

Practice addresses (Care Compare)

1068 W Baltimore PK
Riddle Memorial Hospital
Media, PA 19063-5177
Phone (610) 566-9400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
SP009567PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Infectious Diseases Medical Associates, LLC CurrentSince Mar 24, 2020 Accepting new patients

Locations

1503 Lansdowne Ave
Ste 3010
Darby, PA 19023
Phone (610) 237-5801

1068 W Baltimore Pike
Media, PA 19063
Phone (610) 566-9400

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.

Hospital & facility affiliations 1

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1154588648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1088 W BALTIMORE PIKE",
            "address_2": "SUITE 2104",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635146",
            "telephone_number": "610-744-2980",
            "fax_number": "610-744-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088 W BALTIMORE PIKE",
            "address_2": "SUITE 2104",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635146",
            "telephone_number": "610-744-2980",
            "fax_number": "610-744-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "CHRISTINA",
        "middle_name": "A",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.