Individual provider Active NPI

Christine Kay Stinnett, SSP

  • School Psychologist
  • Belleville, IL
National Provider Identifier
1760907240
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
1873994 Issued in IL
Practice address
111 Warrior Way
Belleville, IL 62221-5117
Phone
(618) 239-0000
Fax
(618) 233-7931
NPI assigned
Aug 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 1873994 IL Primary

Addresses

Primary practice location

111 Warrior Way
Belleville, IL 62221-5117

Mailing address

5242 Duke Dr
Fairview HTS, IL 62208-3909
Phone (618) 558-2226

Other practice location 1

2028 Lebanon Ave
Belleville, IL 62221-2523
Phone (618) 239-0000 ext. 2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1873994ILMDSchool Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Whiteside School District 115 Past Accepting new patients

Organizations & group practices 1

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": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1760907240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5242 DUKE DR",
            "city": "FAIRVIEW HTS",
            "state": "IL",
            "postal_code": "622083909",
            "telephone_number": "618-558-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WARRIOR WAY",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215117",
            "telephone_number": "618-239-0000",
            "fax_number": "618-233-7931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2028 Lebanon Ave",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622212523",
            "country_code": "US",
            "telephone_number": "618-239-0000 x2300",
            "fax_number": "618-233-7931",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STINNETT",
        "first_name": "CHRISTINE",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "SSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IL",
            "license": "1873994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.