Jewel Radford, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.031195 Issued in IL

Practice address

601 James R Thompson Blvd Ste 2015
East Saint Louis, IL 62201-1118

Phone

(618) 482-6959

NPI assigned

Aug 14, 2023

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

Southern Illinois University School of Medicine, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Board of Trustees of Southern Illinois UniversityGroup PAC ID 3173749157, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• Board of Trustees of Southern Illinois University

  • Nurse Practitioner
  • East Saint Louis, IL
  • NPI 1104230168
  Medicare reassignment Care Compare group NPD
• Southern Illinois Regional Wellness Center

  • Federally Qualified Health Center (FQHC)
  • East Saint Louis, IL
  • NPI 1336258540
  NPD (past)

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1083397202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JAMES R THOMPSON BLVD BLDG D",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622011118",
            "telephone_number": "618-482-6959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JAMES R THOMPSON BLVD STE 2015",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622011118",
            "telephone_number": "618-482-6959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADFORD",
        "first_name": "JEWEL",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.031195",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.031195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Pruett, RDN
• Kayla Ann Pryor, APRN
• Leah Pulley
• Pure Living Recovery and Rehabilition Center
• Quality Home Care Solutions Inc
• Roadside Medical, LLC
• Karnaldo Ross
• Songyoth Sakdisri, MD
• Erin Deneen Sanders
• Charles Scheer, NP

• Family Nurse Practitioner in East Saint Louis, IL
• Providers in East Saint Louis, 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 Sep 15, 2025; 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.