Individual provider Active NPI

Jaela N. Flowers, APRN, CNP

  • Family Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1093290579
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018301 Issued in IL
Practice address
501 N 1St St
Springfield, IL 62702-5115
Phone
(217) 788-3792
Fax
(217) 788-5562
NPI assigned
Oct 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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 209018301 IL Primary

Addresses

Primary practice location

501 N 1St St
Springfield, IL 62702-5115

Mailing address

501 N 1St St
Springfield, IL 62702-5115
Phone (217) 788-3792

Other identifiers 1

IdentifierTypeStateIssuer
041368256OtherILRN LICENSE

Other names 1

  • Jaela N. Newbold 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
I20181204000672 IL Practitioner - Nurse Practitioner 9537403415 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Medical CenterGroup PAC ID 7315835949, 131 clinicians

Practice addresses (Care Compare)

501 N 1St St
Springfield, IL 62702-5115
Phone (217) 788-3792

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209018301ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Medical Center CurrentSince Aug 9, 2021 Accepting new patients
Memorial Medical Center Current Accepting new patients
Memorial Medical Center CurrentSince Aug 9, 2021 Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Memorial Medical Center Past Accepting new patients

Locations

1025 S 6th St
Springfield, IL 62703

501 N 1st St
Springfield, IL 62702
Phone (217) 788-3792

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

701 N 1st St
Springfield, IL 62781
Phone (217) 788-3100

Interoperability endpoints

  • Direct secure messaging: jaelaflowers@sfc.allscriptsdirect.net

Organizations & group practices 5

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 3

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": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1093290579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025115",
            "telephone_number": "217-788-3792",
            "fax_number": "217-788-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025115",
            "telephone_number": "217-788-3792",
            "fax_number": "217-788-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLOWERS",
        "first_name": "JAELA",
        "middle_name": "N.",
        "credential": "APRN, CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-01",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041368256",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAELA",
            "last_name": "NEWBOLD",
            "middle_name": "N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.