Individual provider Active NPI

Elizabeth Anne Hayes, APN

  • Family Nurse Practitioner
  • Morton, IL
National Provider Identifier
1134484041
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
041.325430 Issued in IL
Practice address
370 E Courtland St
Morton, IL 61550-9054
Phone
(309) 291-0899
Fax
(309) 291-0927
NPI assigned
Jul 6, 2012
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 041.325430 IL Primary

Addresses

Primary practice location

370 E Courtland St
Morton, IL 61550-9054

Mailing address

370 E Courtland St
Morton, IL 61550-9054
Phone (309) 291-0899

Other names 1

  • Elizabeth Anne Sheen Former name

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
I20120920000094 IL Practitioner - Nurse Practitioner 4880842657 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041.325430ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Methodist Medical Center of Illinois Family CurrentSince Aug 1, 2017 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 1, 2017 Accepting new patients
CB Laboratory LLC Current Accepting new patients
A Balanced Life Medical Services LLC Past Accepting new patients
Comprehensive Emergency Solutions SC Past Accepting new patients

Locations

370 E Courtland St
Morton, IL 61550
Phone (309) 291-0899

120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

Interoperability endpoints

  • Direct secure messaging: hayes-elizabeth@a75f887d.micromddirect.com

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, 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": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1134484041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 E COURTLAND ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615509054",
            "telephone_number": "309-291-0899",
            "fax_number": "309-291-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 E COURTLAND ST",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615509054",
            "telephone_number": "309-291-0899",
            "fax_number": "309-291-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYES",
        "first_name": "ELIZABETH",
        "middle_name": "ANNE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041.325430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "SHEEN",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morton, IL

Sources for this page

Verify at the official NPI Registry.