Individual provider Active NPI

Cristina Whitehead, FNP

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1841057833
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F09230966 Issued in SC
Practice address
690 Columbiana Dr Ste B
Columbia, SC 29212-1656
Phone
(803) 736-3277
Fax
(803) 408-8698
NPI assigned
Mar 5, 2024
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F09230966 SC Primary

Addresses

Primary practice location

690 Columbiana Dr Ste B
Columbia, SC 29212-1656

Mailing address

15 Exchange Dr
Lugoff, SC 29078-9198
Phone (803) 408-3277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240419002103 SC Practitioner - Nurse Practitioner 5890134027 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Medical University of South Carolina College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Carolina ENT Allergy and Sleep Medicine PAGroup PAC ID 0840214748, 24 clinicians

Practice addresses (Care Compare)

690 Columbiana Dr
Suite B
Columbia, SC 29212-1656
Phone (803) 408-3277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F09230966SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina ENT Allergy & Sleep Medicine PA CurrentSince Mar 11, 2024 Accepting new patients

Locations

690 Columbiana Dr
Ste B
Columbia, SC 29212
Phone (803) 376-2838

15 Exchange Dr
Lugoff, SC 29078
Phone (803) 424-2207

Interoperability endpoints

  • Direct secure messaging: cwhitehead640832@direct.ghs.myhfn.org

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, 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": "1709596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1841057833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 EXCHANGE DR",
            "city": "LUGOFF",
            "state": "SC",
            "postal_code": "290789198",
            "telephone_number": "803-408-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 COLUMBIANA DR STE B",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292121656",
            "telephone_number": "803-736-3277",
            "fax_number": "803-408-8698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "CRISTINA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "F09230966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.