Individual provider Active NPI

Lorie Sporrer, FNP-BC

  • Family Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1053739201
Registry record updated Apr 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-011323 Issued in IL
Practice address
415 N 9TH St
Suite 6W100
Springfield, IL 62702-5303
Phone
(217) 545-8000
Fax
(217) 545-0112
NPI assigned
Apr 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2014

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 209-011323 IL Primary

Addresses

Primary practice location

415 N 9TH St
Suite 6W100
Springfield, IL 62702-5303

Mailing address

PO Box 19640
Springfield, IL 62794-9640
Phone (217) 545-8000

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
I20140418000654 IL Practitioner - Nurse Practitioner 4486886702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

301 N 8TH St
Springfield, IL 62701-1041
Phone (217) 545-8000

315 W Carpenter St
Springfield, IL 62702-4901
Phone (217) 545-8000

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-011323ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Mar 17, 2014 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Mar 17, 2014 Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

315 W Carpenter St
Fl 2
Springfield, IL 62702
Phone (217) 545-1025

415 N 9th St
Ste 6W100
Springfield, IL 62702
Phone (217) 545-5117

301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003

Interoperability endpoints

  • Direct secure messaging: loriesporrer@siusm.allscriptsdirect.net

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": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398124800000",
    "number": "1053739201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19640",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949640",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N 9TH ST",
            "address_2": "SUITE 6W100",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025303",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORRER",
        "first_name": "LORIE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2014-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-011323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.