Individual provider Active NPI

George Brummell, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Carthage, IL
National Provider Identifier
1114693181
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209026348 Issued in IL
Practice address
1450 N County Road 2050 E
Carthage, IL 62321-3551
Phone
(217) 357-6888
NPI assigned
Aug 19, 2021
Last updated
Jul 3, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X AP61194142 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209026348 IL Primary

Addresses

Primary practice location

1450 N County Road 2050 E
Carthage, IL 62321-3551

Mailing address

1450 N County Road 2050 E
Carthage, IL 62321-3551
Phone (217) 357-6888

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
I20230309000726 IL Practitioner - Nurse Practitioner 3971909540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital AssociationGroup PAC ID 0244134682, 39 clinicians

Practice addresses (Care Compare)

1454 N Co Rd 2050
Carthage, IL 62321-0160

1454 N County Rd
Carthage, IL 62321-0160
Phone (217) 357-8500

PO Box
Carthage, IL 62321-0160

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209026348ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Memorial Hospital Association Current Accepting new patients
Memorial Hospital Association CurrentSince Jan 19, 2023 Accepting new patients
Memorial Hospital Association CurrentSince Jan 19, 2023 Accepting new patients
Memorial Hospital Association Past Accepting new patients
Memorial Hospital Association Past Accepting new patients
Memorial Hospital Association Past Accepting new patients

Locations

209 E 5th St
Bowen, IL 62316
Phone (217) 842-5211

1450 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-2173

1454 N County Road 2050 E
Carthage, IL 62321
Phone (217) 357-3131

630 Locust St
Carthage, IL 62321
Phone (217) 357-2173

630 Locust St
Ste A
Carthage, IL 62321

1471 Keokuk St
Hamilton, IL 62341
Phone (217) 847-3383

951 Broadway St
Hamilton, IL 62341
Phone (217) 551-3100

501 E Main St
La Harpe, IL 61450
Phone (217) 659-3844

Interoperability endpoints

  • Direct secure messaging: gbrummell932803@direct.unitypoint.org

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.

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": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1114693181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 N COUNTY ROAD 2050 E",
            "city": "CARTHAGE",
            "state": "IL",
            "postal_code": "623213551",
            "telephone_number": "217-357-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 N COUNTY ROAD 2050 E",
            "city": "CARTHAGE",
            "state": "IL",
            "postal_code": "623213551",
            "telephone_number": "217-357-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMMELL",
        "first_name": "GEORGE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-19",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "WA",
            "license": "AP61194142",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209026348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, IL

Sources for this page

Verify at the official NPI Registry.