Individual provider Active NPI

Jamie Joann Rinehart, PA

  • Physician Assistant
  • Springfield, IL
National Provider Identifier
1104302561
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.006608 Issued in IL
Practice address
800 E Carpenter St
Springfield, IL 62702-5324
Phone
(217) 544-6464
NPI assigned
Jul 18, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.006608 IL Primary

Addresses

Primary practice location

800 E Carpenter St
Springfield, IL 62702-5324

Mailing address

111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272

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
I20181029002539 IL Practitioner - Physician Assistant 0143573733 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians

Practice addresses (Care Compare)

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5522

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 740-4272

530 Neglen Oak Ave
Peoria, IL 61636-0001
Phone (309) 655-2000

Hospital & facility affiliations

  • St Johns Hospital Hospital, Springfield, IL, CCN 140053
  • St Francis Hospital Hospital, Litchfield, IL, CCN 141350

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.006608ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Jun 3, 2019 Accepting new patients
SJL Health Systems Inc CurrentSince Jun 3, 2019 Accepting new patients
Cira Michigan PC Past Accepting new patients

Locations

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

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 2

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": "1531872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1104302561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OAKWOOD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111853",
            "telephone_number": "309-740-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E CARPENTER ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025324",
            "telephone_number": "217-544-6464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINEHART",
        "first_name": "JAMIE",
        "middle_name": "JOANN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-18",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.