Active NPI
Michelle Lee Geiss, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Jacksonville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 209.018271
- Practice address
- 1600 W Walnut St
Jacksonville, IL 62650-1136 - Phone
- (217) 245-7275
- NPI assigned
- Oct 2, 2018
- Last updated
- Oct 2, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209.018271 | IL | Primary |
Addresses
Primary practice location
1600 W Walnut St
Jacksonville, IL 62650-1136
Mailing address
70 Navajo Dr
Springfield, IL 62711-6084
Phone (309) 210-9339
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
Enrollment records 1
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
Practice addresses (Care Compare)
319 E Madison St
FL 3
Springfield, IL 62701-1035
Phone (217) 545-8000
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.018271 | IL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients | |
| Board of Trustees of Southern Illinois University | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients |
Locations
1600 W Walnut St
South Jacksonville, IL 62650
Phone (217) 245-7275
301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003
319 E Madison St
Fl 3
Springfield, IL 62701
Phone (217) 545-7627
Interoperability endpoints
- michellegeiss@siusm.allscriptsdirect.net
Organizations & group practices 3
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.
-
dba SIU HealthCare
- Endocrinology, Diabetes & Metabolism Physician
- Springfield, IL
- NPI 1558385989
-
dba Carbondale Care A Van
- Rural Health Clinic/Center
- Carbondale, IL
- NPI 1215978127
-
- Durable Medical Equipment & Medical Supplies
- Springfield, IL
- NPI 1164055976
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538438400000",
"number": "1114402518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 NAVAJO DR",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627116084",
"telephone_number": "309-210-9339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 W WALNUT ST",
"city": "JACKSONVILLE",
"state": "IL",
"postal_code": "626501136",
"telephone_number": "217-245-7275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEISS",
"first_name": "MICHELLE",
"middle_name": "LEE",
"credential": "PMHNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-02",
"last_updated": "2018-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "209.018271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, IL
- Gateway Foundation, Inc. - BHC (Alpharus Health)
- Gateway Professional Services, PC
- Alicia K Gatti, LMFT
- Cassidy K Gaudio, MSW, LCSW
- Terry Lee Geirnaeirt, ATC
- Antonia J Genisio, LCPC
- Allen G Gerberding, M.D.
- Eric A Giebelhausen, MD
- Jordan Amanda Gill, LSW
- Gillespie 694140 (Jacksonville Developmental Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.