Nicole Suzette Soper, APN FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209014230 Issued in IL

Practice address

302 W Hay St
Decatur, IL 62526-4167

Phone

(217) 545-8000

NPI assigned

May 10, 2016

Last updated

Nov 25, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135
• St Marys Hospital Hospital, Decatur, IL, CCN 140166
• HSHS Good Shepherd Hospital Inc Hospital, Shelbyville, IL, CCN 141354
• St Johns Hospital Hospital, Springfield, IL, CCN 140053
• Kirby Medical Center Hospital, Monticello, IL, CCN 141301

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

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

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.

• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment Care Compare group NPD
• Board of Trustees of Southern Illinois University

  dba Carbondale Care A Van

  • Rural Health Clinic/Center
  • Carbondale, IL
  • NPI 1215978127
  NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD
• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1164477725
  NPD (past)
• Decatur Memorial Hospital

  dba Professional Fees

  • Multi-Specialty Clinic/Center
  • Decatur, IL
  • NPI 1477276301
  NPD (past)
• Siu Physicians & Surgeons, Inc

  • Pediatrics Physician
  • Springfield, IL
  • NPI 1285657379
  NPD (past)

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

• Decatur Memorial Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1548357973
  Care Compare affiliation
• HSHS Good Shepherd Hospital Inc

  • Critical Access Hospital
  • Shelbyville, IL
  • NPI 1053348532
  Care Compare affiliation
• Kirby Medical Center

  dba Kirby Ambulance

  • Land Ambulance
  • Monticello, IL
  • NPI 1598869133

  Hospital

  Care Compare affiliation
• Kirby Medical Center

  • Critical Access Hospital
  • Monticello, IL
  • NPI 1730179847
  Care Compare affiliation
• St Johns Hospital of the Hospital Sisters of the Third Order of St F

  dba HSHS St. John's Hospital

  • General Acute Care Hospital
  • Springfield, IL
  • NPI 1205818481
  Care Compare affiliation
• St Marys Hospital Decatur of the Hospital Sisters of the Third Order

  dba St Marys Hospital

  • General Acute Care Hospital
  • Decatur, IL
  • NPI 1326041229
  Care Compare affiliation

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1073969044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MADISON ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025131",
            "telephone_number": "217-545-3787",
            "fax_number": "217-762-3949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 W HAY ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264167",
            "telephone_number": "217-545-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1709 S Fairview Ave",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "62521",
            "country_code": "US",
            "telephone_number": "217-429-2551",
            "fax_number": "217-429-2942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOPER",
        "first_name": "NICOLE",
        "middle_name": "SUZETTE",
        "credential": "APN FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014230",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041330758",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amorkor Sogbodjor
• Cathy J Solomon, LPT
• Angela Elena Solon
• Kristina Linda Sommer
• Vinay Soni, PHARM.D.
• Terry Soper, NP
• Barbara J Sowa
• Zachary Lee Sowa, P.A.
• Rachel Beth Spaide, MS, OTR/L
• Nealita C Spann, MA LPC

• Family Nurse Practitioner in Decatur, IL
• Providers in Decatur, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.