Individual provider Active NPI

Crystal H White, APN-C

  • Family Nurse Practitioner
  • Paris, IL
National Provider Identifier
1184978009
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277000678 Issued in IL
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

Updated by the provider on May 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
539646497001MedicaidIL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170306001817 IL Practitioner - Nurse Practitioner 4183864689 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209009792ILMDFamily Nurse Practitioner
277000678ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital & Medical Foundation of Paris, Inc. CurrentSince Feb 1, 2017 Accepting new patients
Hospital & Medical Foundation of Paris, Inc. Current Accepting new patients
Hospital & Medical Foundation of Paris, Inc. CurrentSince Feb 1, 2017 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

  • Direct secure messaging: crystal.white.2@11356.direct.athenahealth.com
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.