Active NPI
Danielle Deisher
- Family Nurse Practitioner
- Lawrenceville, IL
National Provider Identifier
1003640434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.030387
- Practice address
- 2101 James St
Lawrenceville, IL 62439-2027 - Phone
- (618) 943-3302
- Fax
- (618) 943-6409
- NPI assigned
- Aug 28, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.030387 | IL | Primary |
Addresses
Primary practice location
2101 James St
Lawrenceville, IL 62439-2027
Mailing address
2101 James St
Lawrenceville, IL 62439-2027
Phone (618) 943-3302
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.030387 | IL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732147200000",
"number": "1003640434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 JAMES ST",
"city": "LAWRENCEVILLE",
"state": "IL",
"postal_code": "624392027",
"telephone_number": "618-943-3302",
"fax_number": "618-943-6409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2101 JAMES ST",
"city": "LAWRENCEVILLE",
"state": "IL",
"postal_code": "624392027",
"telephone_number": "618-943-3302",
"fax_number": "618-943-6409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEISHER",
"first_name": "DANIELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-28",
"last_updated": "2024-11-21",
"certification_date": "2024-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.030387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.