Individual provider Active NPI

Abbey Dempsey

  • Nurse Practitioner
  • Centralia, IL
National Provider Identifier
1104287598
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209014046 Issued in IL
Practice address
1307 E McCord St
Centralia, IL 62801-3610
Phone
(618) 899-9200
Fax
(618) 899-9206
NPI assigned
Mar 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209014046 IL Primary

Addresses

Primary practice location

1307 E McCord St
Centralia, IL 62801-3610

Mailing address

1307 E McCord St
Centralia, IL 62801-3610
Phone (618) 899-9200

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
I20160707000835 IL Practitioner - Nurse Practitioner 5698067924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1307 E McCord St
Centralia, IL 62801-3610
Phone (618) 899-9200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209014046ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Surgical Technology, LLC CurrentSince May 25, 2016 Accepting new patients
Advanced Surgical Technology, LLC CurrentSince May 25, 2016 Accepting new patients

Locations

432 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5200

400 Rushing Dr
Herrin, IL 62948
Phone (618) 899-9200

4200 Williamson Pl
#1A
Mount Vernon, IL 62864
Phone (618) 899-9195

Interoperability endpoints

  • Direct secure messaging: aburto13@yourcarecommunity.org
  • Direct secure messaging: advancedsurgicaltechnology.abbeygettinger@131021.advancedmd-direct.com
  • Direct secure messaging: agettinger168044@direct-ehr-ssmhc.com

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ast Primary Care HoyletonHoyleton, IL, CCN 783862 Rural health clinic W-2 Managing Employee Jul 1, 2023
Ast Primary Care CarlyleCarlyle, IL, CCN 783861 Rural health clinic W-2 Managing Employee Jul 1, 2023

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 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": "1457654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1104287598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 E MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013610",
            "telephone_number": "618-899-9200",
            "fax_number": "618-899-9206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 E MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013610",
            "telephone_number": "618-899-9200",
            "fax_number": "618-899-9206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMPSEY",
        "first_name": "ABBEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-11",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209014046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

Verify at the official NPI Registry.