Individual provider Active NPI

Alexandra Irene Evans, FNP-BC

  • Family Nurse Practitioner
  • Jerseyville, IL
National Provider Identifier
1134719537
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209025504 Issued in IL
Practice address
390 Maple Summit Rd
Jerseyville, IL 62052-2000
Phone
(618) 498-2101
Fax
(618) 498-8153
NPI assigned
Jan 20, 2021
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209025504 IL Primary
Nurse Practitioner 363L00000X 209025504 IL

Addresses

Primary practice location

390 Maple Summit Rd
Jerseyville, IL 62052-2000

Mailing address

390 Maple Summit Rd
Jerseyville, IL 62052-2000
Phone (184) 987-5186

Other practice location 1

523 S Main St
Carrollton, IL 62016-1256
Phone (217) 942-3326

Other practice location 2

414 S State St
Roodhouse, IL 62082-1544
Phone (217) 589-4383

Other practice location 3

903 S State St
Jerseyville, IL 62052-2344
Phone (618) 639-9255

Other practice location 4

400 Maple Summit Rd
Jerseyville, IL 62052-2028
Phone (618) 498-2101

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aevans1@jch.cernerdirect.com Health Information Exchange (HIE)

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
I20220830002628 IL Practitioner - Nurse Practitioner 7315321049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jersey Community HospitalGroup PAC ID 4587650445, 62 clinicians

Practice addresses (Care Compare)

903 S State St
Jerseyville, IL 62052-2344
Phone (618) 639-9255

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.05 of 100Reported as apm
Quality
72.1
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jersey Community Hospital District Family CurrentSince Sep 1, 2022 Accepting new patients
Jersey Community Hospital CurrentSince Sep 1, 2022 Accepting new patients
Jersey Community Hospital Current Accepting new patients
Jersey Community Hospital District Past Accepting new patients
Jersey Community Hospital Past Accepting new patients

Locations

523 S Main St
Carrollton, IL 62016
Phone (217) 348-3326

390 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-2101

400 Maple Summit Rd
Jerseyville, IL 62052
Phone (618) 498-6402

903 S State St
Jerseyville, IL 62052
Phone (618) 498-8806

414 S State St
Roodhouse, IL 62082
Phone (217) 589-4383

Interoperability endpoints

  • Direct secure messaging: aevans1@jch.cernerdirect.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.

Hospital & facility affiliations 1

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": "1611100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1134719537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 MAPLE SUMMIT RD",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522000",
            "telephone_number": "184-987-5186",
            "fax_number": "618-498-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 MAPLE SUMMIT RD",
            "city": "JERSEYVILLE",
            "state": "IL",
            "postal_code": "620522000",
            "telephone_number": "618-498-2101",
            "fax_number": "618-498-8153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "523 S Main St",
            "address_purpose": "LOCATION",
            "city": "Carrollton",
            "state": "IL",
            "postal_code": "620161256",
            "country_code": "US",
            "telephone_number": "217-942-3326",
            "fax_number": "217-942-9833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "414 S State St",
            "address_purpose": "LOCATION",
            "city": "Roodhouse",
            "state": "IL",
            "postal_code": "620821544",
            "country_code": "US",
            "telephone_number": "217-589-4383",
            "fax_number": "217-589-4409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "903 S State St",
            "address_purpose": "LOCATION",
            "city": "Jerseyville",
            "state": "IL",
            "postal_code": "620522344",
            "country_code": "US",
            "telephone_number": "618-639-9255",
            "fax_number": "618-639-8100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Maple Summit Rd",
            "address_purpose": "LOCATION",
            "city": "Jerseyville",
            "state": "IL",
            "postal_code": "620522028",
            "country_code": "US",
            "telephone_number": "618-498-2101",
            "fax_number": "618-498-8453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EVANS",
        "first_name": "ALEXANDRA",
        "middle_name": "IRENE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-20",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209025504",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209025504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aevans1@jch.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "HIE JERSEY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "390 Maple Summit Rd",
            "city": "Jerseyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620522000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jerseyville, IL

Sources for this page

Verify at the official NPI Registry.