Individual provider Active NPI

Kristina Marie Whitten, FNP

  • Family Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1487251617
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28257 Issued in TN
Practice address
8060 Wolf River Blvd
Germantown, TN 38138-1727
Phone
(901) 271-1000
NPI assigned
Oct 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 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 28257 TN Primary
Nurse Practitioner 363L00000X 28257 TN

Addresses

Primary practice location

8060 Wolf River Blvd
Germantown, TN 38138-1727

Mailing address

8060 Wolf River Blvd
Germantown, TN 38138-1727
Phone (901) 271-1000

Other identifiers 1

IdentifierTypeStateIssuer
Q061229MedicaidTN

Other names 1

  • Kristina Marie McDowell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20201027002711 TN Practitioner - Nurse Practitioner 8921418245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stern Cardiovascular Foundation, IncGroup PAC ID 8123200540, 111 clinicians

Practice addresses (Care Compare)

8060 Wolf River Blvd
Germantown, TN 38138-1727
Phone (901) 271-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28257TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Stern Cardiovascular Center, PA Current Accepting new patients
Stern Cardiovascular Foundation, Inc CurrentSince Oct 1, 2020 Accepting new patients

Locations

8060 Wolf River Blvd
Memphis, TN 38138
Phone (901) 271-2272

Organizations & group practices 2

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": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1487251617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8060 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381727",
            "telephone_number": "901-271-1000",
            "fax_number": "901-271-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8060 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381727",
            "telephone_number": "901-271-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTEN",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "28257",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "28257",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q061229",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "MCDOWELL",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.