Individual provider Active NPI

Stephanie D Jackson, APRN

  • Family Nurse Practitioner
  • Effingham, IL
National Provider Identifier
1073258380
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.025152 Issued in IL
Practice address
900 W Temple Ave Ste 1500
Effingham, IL 62401-2121
Phone
(217) 347-0458
NPI assigned
May 2, 2022
Last updated
Jun 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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 209.025152 IL Primary

Addresses

Primary practice location

900 W Temple Ave Ste 1500
Effingham, IL 62401-2121

Mailing address

900 W Temple Ave
Effingham, IL 62401-2121
Phone (217) 347-0458

Other practice location 1

1901 S 4th St Ste 26
Effingham, IL 62401-4188
Phone (217) 660-4600

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjackson361514@ewd.direct.hshs.org Direct

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
I20230324001978 IL Practitioner - Nurse Practitioner 9234503863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

1836 S Macarthur Blvd
Springfield, IL 62704-4030
Phone (217) 789-1403

1900 E Lake Shore Dr
Suite 330
Decatur, IL 62521-3848
Phone (217) 423-2889

207 S Main St
Dieterich, IL 62424-1128
Phone (217) 952-5730

601 W Washington St
Newton, IL 62448-1264
Phone (618) 783-0954

900 W Temple Ave
Effingham, IL 62401-2121
Phone (217) 540-2350

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.025152ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Jun 1, 2025 Accepting new patients
SJL Health Systems Inc CurrentSince Jun 1, 2025 Accepting new patients
Jackson Health, PLLC Family CurrentSince Feb 6, 2023 Accepting new patients
HSHS Medical Group Inc Current Accepting new patients
HSHS Medical Group Inc PastSince Jun 29, 2025 Accepting new patients
HSHS Medical Group Inc Past Accepting new patients
Consolidated Community Medical Centers, S.C. PastSince May 1, 2022 Accepting new patients

Locations

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

1901 S 4th St
Ste 26
Effingham, IL 62401
Phone (217) 660-4600

900 W Temple Ave
Effingham, IL 62401
Phone (217) 347-5525

900 W Temple Ave
Ste 1500
Effingham, IL 62401
Phone (217) 347-0458

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321

Interoperability endpoints

  • Direct secure messaging: sjackson361514@ewd.direct.hshs.org

Organizations & group practices 7

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.

Hospital & facility affiliations 6

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": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1073258380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W TEMPLE AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012121",
            "telephone_number": "217-347-0458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W TEMPLE AVE STE 1500",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012121",
            "telephone_number": "217-347-0458"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1901 S 4th St Ste 26",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624014188",
            "country_code": "US",
            "telephone_number": "217-660-4600",
            "fax_number": "217-334-0027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "STEPHANIE",
        "middle_name": "D",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.025152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjackson361514@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "900 W Temple Ave Ste 1500",
            "city": "Effingham",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624012121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

Verify at the official NPI Registry.