Jennifer Melissa Powell, MD
Individual provider Active NPI Family Medicine Physician · Momence, IL
NPI 1124131966 · NPPES record last updated Nov 8, 2021
Key facts
- NPI
- 1124131966
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036110704 (IL)
- Practice address
- 3761 N State Route 1 17
Momence, IL 60954-2400 - Phone
- (815) 472-3923
- Fax
- (815) 472-2816
- NPI assigned
- Aug 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Cincinnati College of Medicine, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Riverside Health System
Practice addresses (Care Compare)
105 S 1St St
Willmington, IL 60481-8973
Phone (815) 476-5210
3761 N State Route 1 17
Momence, IL 60954-2400
Phone (815) 472-3923
Hospital & facility affiliations
- R.M.C. Home Health Care
- Uplifted Care
- Riverside Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130419000372 | IL | Practitioner - Family Practice | 9931345832 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Infant Welfare Society of Chicago | Current |
Accepting new patients | |
| Riverside Health System | Current | Accepting new patients | |
| Riverside Health System | Current |
Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666
3600 W Fullerton Ave
Chicago, IL 60647
Phone (773) 782-2800
720 S Crescent St
Gilman, IL 60938
Phone (815) 265-4255
1905 W Court St
Kankakee, IL 60901
Phone (815) 933-2240
350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500
3761 N State Route 1 17
Momence, IL 60954
Phone (815) 472-3923
611 S Division St
Peotone, IL 60468
Phone (708) 258-9058
105 S First St
Wilmington, IL 60481
Phone (815) 476-5210
Interoperability endpoints
- jpowell7668@direct.riversidehealthcare.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036110704 | IL | Yes |
Addresses
Primary practice location
3761 N State Route 1 17
Momence, IL 60954-2400
Mailing address
3761 N State Route 1 17
Momence, IL 60954-2400
Phone (815) 472-3923
Other practice location 1
3600 W Fullerton Ave
Chicago, IL 60647-2319
Phone (773) 782-2800
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jpowell7668@Direct.riversidehealthcare.net | Direct | |
| Direct Messaging Address | jennifer.powell.1@17986.direct.athenahealth.com |
Other providers in Momence, IL
- Momence Community Unit School District #1
- Momence District #1
- Momence Meadows Nursing & Rehabilitation Center
- Momence Meadows Nursing and Rehabilitation Center
- Dana Marie Nunamaker
- RTW Services PLLC
- Stonecrest Manor Assisted Living
- Lisa J Thompson-Dyson
- Mandi Ann Troli
- Robert Wirick
All providers in Momence, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.