Active NPI
Jessie Nicole Fox
- Nurse Practitioner
- Marion, IL
National Provider Identifier
1033768577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209020010
- Practice address
- 2808 Outer Dr
Marion, IL 62959-5207 - Phone
- (618) 993-3817
- NPI assigned
- Sep 7, 2019
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209020010 | IL | Primary |
Addresses
Primary practice location
2808 Outer Dr
Marion, IL 62959-5207
Mailing address
PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jfox28833@sih.direct-ci.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567814400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1033768577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3988",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629023988",
"telephone_number": "618-457-5200",
"fax_number": "618-529-0586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2808 OUTER DR",
"city": "MARION",
"state": "IL",
"postal_code": "629595207",
"telephone_number": "618-993-3817"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOX",
"first_name": "JESSIE",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-07",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209020010",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jfox28833@sih.direct-ci.com",
"affiliation": "N",
"address_1": "2808 Outer Dr",
"city": "Marion",
"state": "IL",
"country_code": "US",
"postal_code": "629595207",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Marion, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.