Individual provider Active NPI

Christie Jo Gesin, APN

  • Nurse Practitioner
  • Rockford, IL
National Provider Identifier
1740709336
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209016515 Issued in IL
Practice address
535 Roxbury Rd
Rockford, IL 61107-5076
Phone
(815) 387-1717
Fax
(815) 387-1718
NPI assigned
Sep 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209016515 IL Primary

Addresses

Primary practice location

535 Roxbury Rd
Rockford, IL 61107-5076

Mailing address

535 Roxbury Rd
Rockford, IL 61107-5076
Phone (815) 387-1717

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
I20171108003389 IL Practitioner - Nurse Practitioner 7416213384 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

535 Roxbury Rd
Rockford, IL 61107-5076
Phone (815) 387-1717

Hospital & facility affiliations

  • Saint Anthony Medical Center Hospital, Rockford, IL, CCN 140233
  • Osf Saint Elizabeth MDL Ctr Hospital, Peru, IL, CCN 140110
  • Osf Saint Katharine Medical Center Hospital, Dixon, IL, CCN 140012
  • Osf Saint Paul Medical Center Hospital, Mendota, IL, CCN 141310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209016515ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Sep 19, 2017 Accepting new patients

Locations

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

5666 E State St
Rockford, IL 61108
Phone (815) 226-2000

535 Roxbury Rd
Rockford, IL 61107
Phone (815) 387-1717

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1505347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740709336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075076",
            "telephone_number": "815-387-1717",
            "fax_number": "815-387-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075076",
            "telephone_number": "815-387-1717",
            "fax_number": "815-387-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GESIN",
        "first_name": "CHRISTIE",
        "middle_name": "JO",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209016515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.