Active NPI
Christina Ann Stoller, AGPCNP-BC
- Internal Medicine Physician
- Moline, IL
National Provider Identifier
1366172645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 209025316
- Practice address
- 550 30TH Ave Ste 12
Moline, IL 61265-5975 - Phone
- (309) 277-1461
- Fax
- (309) 736-1152
- NPI assigned
- Jun 10, 2022
- Last updated
- Jul 14, 2026
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 209.025316 | IL | |
| Registered Nurse | 163W00000X | 041.399791 | IL | |
| Internal Medicine Physician | 207R00000X | 209025316 | IL | Primary |
Addresses
Primary practice location
550 30TH Ave Ste 12
Moline, IL 61265-5975
Mailing address
550 30TH Ave Ste 12
Moline, IL 61265-5975
Phone (309) 277-1461
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.399791 | IL | MD | Registered Nurse |
| 209.025316 | IL | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jai Swaminarayan Inc | Current | Accepting new patients | |
| St Luke's Methodist Hospital | Current | Accepting new patients | |
| Thomas D Ade MD PLLC | Current | Accepting new patients |
Locations
4350 7th St
Ste B
Moline, IL 61265
Phone (309) 517-1180
550 30th Ave
Ste 12
Moline, IL 61265
Phone (309) 736-5568
Interoperability endpoints
- cstoller978962@direct.unitypoint.org
Organizations & group practices 3
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.
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-
- General Acute Care Hospital
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- NPI 1083708226
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1654819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783987200000",
"number": "1366172645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 30TH AVE STE 12",
"city": "MOLINE",
"state": "IL",
"postal_code": "612655975",
"telephone_number": "309-277-1461",
"fax_number": "309-736-1152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 30TH AVE STE 12",
"city": "MOLINE",
"state": "IL",
"postal_code": "612655975",
"telephone_number": "309-277-1461",
"fax_number": "309-736-1152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLLER",
"first_name": "CHRISTINA",
"middle_name": "ANN",
"credential": "AGPCNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-10",
"last_updated": "2026-07-14",
"certification_date": "2026-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "IL",
"license": "209.025316",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041.399791",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "209025316",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.