Cristy M Lane, MS FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209003603 Issued in IL

Practice address

120 W Main St
Elmwood, IL 61529

Phone

(309) 742-2921

Fax

(309) 742-8411

NPI assigned

Apr 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Miss Cristy M Willett Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Mark C. Baylor, M.D.

  • Family Medicine Physician
  • Elmwood, IL
  • NPI 1437337342
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1669434668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N PROMENADE ST",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626441243",
            "telephone_number": "309-543-6600",
            "fax_number": "309-543-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W MAIN ST",
            "city": "ELMWOOD",
            "state": "IL",
            "postal_code": "61529",
            "telephone_number": "309-742-2921",
            "fax_number": "309-742-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "CRISTY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MS  FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209003603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "198663",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "500011117",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "099052",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "7200613",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTY",
            "last_name": "WILLETT",
            "middle_name": "M",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elmwood Chiropractic P.C.
• Elmwood District 322
• Pamela J Garner, MS FNP
• Graham Hospital Association
• Kristen Jackson, FNP-C
• Local Health, Inc
• Mark C. Baylor, M.D.
• More Than Milk, LLC
• Jacob M Osmulski, DC
• Nathalie Snider, FNP-C

• All providers in Elmwood, IL
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.

Verify at the official NPI Registry.