Active NPI
Crystal H White, APN-C
- Family Nurse Practitioner
- Paris, IL
National Provider Identifier
1184978009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 277000678
- Practice address
- 721 E Court St
Paris, IL 61944-2460 - Phone
- (217) 465-8411
- Fax
- (217) 463-3184
- NPI assigned
- Oct 30, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209009792 | IL | |
| Family Nurse Practitioner | 363LF0000X | 277000678 | IL | Primary |
Addresses
Primary practice location
721 E Court St
Paris, IL 61944-2460
Mailing address
727 E Court St
Paris, IL 61944-2460
Phone (217) 465-8411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 539646497001 | Medicaid | IL |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209009792 | IL | MD | Family Nurse Practitioner |
| 277000678 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital & Medical Foundation of Paris, Inc. | Current | Accepting new patients | |
| Hospital & Medical Foundation of Paris, Inc. | Current | Accepting new patients | |
| Hospital & Medical Foundation of Paris, Inc. | Current | Accepting new patients | |
| Hospital & Medical Foundation of Paris, Inc. | Past | Accepting new patients |
Locations
727 E Court St
Paris, IL 61944
Phone (217) 465-4141
721 E Court St
Paris, IL 61944
Phone (217) 465-4141
Interoperability endpoints
- crystal.white.2@11356.direct.athenahealth.com
- crystal.white.1@23284.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Critical Access Hospital
- Paris, IL
- NPI 1679502322
-
- Rural Health Clinic/Center
- Chrisman, IL
- NPI 1447314653
-
- Clinic/Center
- Paris, IL
- NPI 1629280367
-
- Physical Therapist
- Terre Haute, IN
- NPI 1962378208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588809600000",
"number": "1184978009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "727 E COURT ST",
"city": "PARIS",
"state": "IL",
"postal_code": "619442460",
"telephone_number": "217-465-8411",
"fax_number": "217-463-3184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "721 E COURT ST",
"city": "PARIS",
"state": "IL",
"postal_code": "619442460",
"telephone_number": "217-465-8411",
"fax_number": "217-463-3184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "CRYSTAL",
"middle_name": "H",
"name_prefix": "Mrs.",
"credential": "APN-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-30",
"last_updated": "2020-05-07",
"certification_date": "2020-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209009792",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "277000678",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "539646497001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Paris, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.