Individual provider Active NPI

Aimee Anderson, QMHP

  • Counselor
  • Macomb, IL
National Provider Identifier
1104394295
Registry record updated Nov 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
900 S Deer Rd
Macomb, IL 61455-2639
Phone
(309) 837-4876
Fax
(309) 833-1531
NPI assigned
Nov 6, 2018
Last updated
Nov 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

900 S Deer Rd
Macomb, IL 61455-2639

Mailing address

900 S Deer Rd
Macomb, IL 61455-2639
Phone (309) 837-4876

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240830003023 IL Practitioner - Mental Health Counselor 0244779478 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District CurrentSince May 18, 2024 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District CurrentSince May 18, 2024 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients

Locations

505 E Grant St
Ste 310
Macomb, IL 61455
Phone (309) 836-1582

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541462400000",
    "number": "1104394295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S DEER RD",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552639",
            "telephone_number": "309-837-4876",
            "fax_number": "309-833-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 S DEER RD",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552639",
            "telephone_number": "309-837-4876",
            "fax_number": "309-833-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "AIMEE",
        "credential": "QMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

Verify at the official NPI Registry.