Individual provider Active NPI

Jayla Breann Langfelder

  • Psychiatric/Mental Health Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1063990273
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.030975 Issued in IL
Practice address
1020 S 5TH St
Springfield, IL 62703-2312
Phone
(217) 544-3143
NPI assigned
Jul 31, 2018
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.030975 IL Primary

Addresses

Primary practice location

1020 S 5TH St
Springfield, IL 62703-2312

Mailing address

1020 S 5TH St
Springfield, IL 62703-2312
Phone (217) 544-3143

Other names 1

  • Jayla Breann Middleton Former name

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
I20250616002658 IL Practitioner - Nurse Practitioner 0648781732 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Killian and Associates SCGroup PAC ID 4082503610, 9 clinicians
Yusuf Salah LLCGroup PAC ID 3577895176, 45 clinicians

Practice addresses (Care Compare)

1020 S 5TH St
Springfield, IL 62703-2312
Phone (217) 544-3143

7300 W College Dr
Suite 101
Palos Heights, IL 60463-1181
Phone (708) 448-8470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.030975ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Killian and Associates SC CurrentSince Mar 5, 2025 Accepting new patients

Locations

1020 S 5th St
Springfield, IL 62703
Phone (217) 544-3143

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1063990273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 S 5TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032312",
            "telephone_number": "217-544-3143",
            "fax_number": "217-544-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S 5TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032312",
            "telephone_number": "217-544-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGFELDER",
        "first_name": "JAYLA",
        "middle_name": "BREANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-31",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.030975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYLA",
            "last_name": "MIDDLETON",
            "middle_name": "BREANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.