Individual provider Active NPI

Christina Elaine Stark, APRN

  • Family Nurse Practitioner
  • Exeter, NH
National Provider Identifier
1801248497
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
073901-23 Issued in NH
Practice address
5 White Oak Dr
Exeter, NH 03833-5317
Phone
(603) 658-3006
Fax
(603) 658-1159
NPI assigned
Jul 7, 2016
Last updated
Oct 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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 073901-23 NH Primary
Family Nurse Practitioner 363LF0000X 073981-23 NH

Addresses

Primary practice location

5 White Oak Dr
Exeter, NH 03833-5317

Mailing address

5 White Oak Dr
Exeter, NH 03833-5317
Phone (603) 658-3006

Other practice location 1

67 Corporate Dr Fl 3
Portsmouth, NH 03801-2847
Phone (603) 610-8050

Other practice location 2

155 Borthwick Ave
Suite 202W
Portsmouth, NH 03801-7156
Phone (603) 433-8434

Other identifiers 1

IdentifierTypeStateIssuer
3105391MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20161017000959 NH Practitioner - Nurse Practitioner 8325336894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
073901-23NHMDFamily Nurse Practitioner
073981-23NHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
On Site Dermatology LLC PastSince Nov 3, 2024 Accepting new patients
Wentworth Douglass Hospital PastSince Feb 1, 2023 Accepting new patients
Ozarks Medical Center Past Accepting new patients

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": "1467849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1801248497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 WHITE OAK DR",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038335317",
            "telephone_number": "603-658-3006",
            "fax_number": "603-658-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 WHITE OAK DR",
            "city": "EXETER",
            "state": "NH",
            "postal_code": "038335317",
            "telephone_number": "603-658-3006",
            "fax_number": "603-658-1159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "67 Corporate Dr Fl 3",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038012847",
            "country_code": "US",
            "telephone_number": "603-610-8050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 Borthwick Ave",
            "address_2": "Suite 202W",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "NH",
            "postal_code": "038017156",
            "country_code": "US",
            "telephone_number": "603-433-8434",
            "fax_number": "603-436-6608",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "CHRISTINA",
        "middle_name": "ELAINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-07",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "073901-23",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "073981-23",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3105391",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Exeter, NH

Sources for this page

Verify at the official NPI Registry.