Individual provider Active NPI

Christina Ann Stoller, AGPCNP-BC

  • Internal Medicine Physician
  • Moline, IL
National Provider Identifier
1366172645
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
209025316 Issued in IL
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, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230217001799 IL Practitioner - Nurse Practitioner 2163894205 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041.399791ILMDRegistered Nurse
209.025316ILMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jai Swaminarayan Inc CurrentSince Oct 1, 2022 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Thomas D Ade MD PLLC CurrentSince Jul 10, 2023 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.