Organization Active NPI

Whole Health Family Practice, PC

  • Family Nurse Practitioner
  • O Fallon, IL
National Provider Identifier
1922476241
Registry record updated May 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209006003 Issued in IL
Legal business name
WHOLE HEALTH FAMILY PRACTICE, PC
Practice address
922 Talon Dr
Suite B
O Fallon, IL 62269-1848
Phone
(618) 622-1200
Fax
(314) 270-5283
NPI assigned
Sep 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2016

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

Authorized official

Name
Ms. Crystal S Jesenick, APN, FNP-C
Title
Family Nurse Practitioner
Phone
(618) 622-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 209006003 IL Primary

Addresses

Primary practice location

922 Talon Dr
Suite B
O Fallon, IL 62269-1848

Mailing address

825 Saybrook Falls Dr
Fairview Heights, IL 62208-2168
Phone (618) 622-1200

National Provider Directory

National Provider Directory

Locations

922 Talon Dr
O Fallon, IL 62269
Phone (618) 622-1200

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462233600000",
    "number": "1922476241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 SAYBROOK FALLS DR",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082168",
            "telephone_number": "618-622-1200",
            "fax_number": "314-270-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 TALON DR",
            "address_2": "SUITE B",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691848",
            "telephone_number": "618-622-1200",
            "fax_number": "314-270-5283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHOLE HEALTH FAMILY PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2016-05-03",
        "status": "A",
        "authorized_official_last_name": "JESENICK",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "618-622-1200",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APN, FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209006003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

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