Individual provider Active NPI

Reiley Eryn Michels, APRN

  • Family Nurse Practitioner
  • Lawrenceville, IL
National Provider Identifier
1023840469
Registry record updated Oct 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.030270 Issued in IL
Practice address
2111 Lexington Ave
Lawrenceville, IL 62439-2085
Phone
(618) 943-7214
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 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 209.030270 IL Primary

Addresses

Primary practice location

2111 Lexington Ave
Lawrenceville, IL 62439-2085

Mailing address

122 Magnolia Dr
Olney, IL 62450-3310
Phone (618) 838-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20241118000839 IL Practitioner - Nurse Practitioner 9335673078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence County Memorial HospitalGroup PAC ID 1850288481, 13 clinicians
Lawrence County Memorial HospitalGroup PAC ID 7517144249, shared by 4 NPIs, 33 clinicians

Practice addresses (Care Compare)

2111 Lexington Ave
Lawrenceville, IL 62439-2085

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.030270ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Pathologists, LLC Current Accepting new patients
Lawrence County Memorial Hospital CurrentSince Oct 8, 2024 Accepting new patients
Lawrence County Memorial Hospital Current Accepting new patients
Lawrence County Memorial Hospital CurrentSince Oct 8, 2024 Accepting new patients

Locations

2200 State St
Lawrenceville, IL 62439
Phone (618) 943-1000

2111 Lexington Ave
Lawrenceville, IL 62439
Phone (618) 943-6202

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729987200000",
    "number": "1023840469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 MAGNOLIA DR",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624503310",
            "telephone_number": "618-838-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 LEXINGTON AVE",
            "city": "LAWRENCEVILLE",
            "state": "IL",
            "postal_code": "624392085",
            "telephone_number": "618-943-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELS",
        "first_name": "REILEY",
        "middle_name": "ERYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-10-27",
        "certification_date": "2024-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.030270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, IL

Sources for this page

Verify at the official NPI Registry.