Misty Dawn Wernsman, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209014985 Issued in IL

Practice address

1052 M L King Dr Ste 2
Centralia, IL 62801-3002

Phone

(618) 436-5410

Fax

(618) 436-8063

NPI assigned

Oct 19, 2016

Last updated

Apr 15, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cancer Care Specialists of Central Illinois SCGroup PAC ID 5991619116, 31 clinicians

Physician Services Corporation of Southern Illinois IncGroup PAC ID 9234022567, 120 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary's Hospital -Centralia Hospital, Centralia, IL, CCN 140034
• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046
• Fireside House of Centralia Nursing home, Centralia, IL, CCN 145791

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwernsman82705@direct-ehr-ssmhc.com

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.

• Cancer Care Specialists of Central Illinois, S.C.

  • Medical Oncology Physician
  • Decatur, IL
  • NPI 1871580142
  Medicare reassignment Care Compare group NPD
• Physician Services Corporation of Southern Illinois Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment Care Compare group NPD
• Good Samaritan Regional Health Center

  dba SSM Health Good Samaritan Hospital - Mt. Vernon

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1487758801
  Medicare reassignment NPD
• Cancer Care Specialists of Central Illinois, S.C

  dba Cancer Care Specialists of Illinois

  • Community/Retail Pharmacy
  • Decatur, IL
  • NPI 1356874093
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Good Samaritan Regional Health Center

  dba SSM Health Good Samaritan Hospital - Mt. Vernon

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339
  Care Compare affiliation
• HCC-Healthcare Properties, LLC

  dba Fireside House of Centralia

  • Skilled Nursing Facility
  • Centralia, IL
  • NPI 1861977019

  Nursing home

  Care Compare affiliation
• St Mary's Hospital, Centralia, Illinois

  dba SSM Health St. Mary's Hospital - Centralia

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1144771692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25228",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625255228",
            "telephone_number": "217-329-3232",
            "fax_number": "217-233-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 M L KING DR STE 2",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013002",
            "telephone_number": "618-436-5410",
            "fax_number": "618-436-8063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Good Samaritan Way",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "IL",
            "postal_code": "628642402",
            "country_code": "US",
            "telephone_number": "618-899-1264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Good Samaritan Way",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "IL",
            "postal_code": "628642402",
            "country_code": "US",
            "telephone_number": "618-242-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WERNSMAN",
        "first_name": "MISTY",
        "middle_name": "DAWN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014985",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209014985",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwernsman82705@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mwernsman82705@direct-ehr-ssmhc.com",
            "address_1": "5 Good Samaritan Way",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642402",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "5 Good Samaritan Way",
            "city": "Mount Vernon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628642402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Halee Weihe
• Amber Lynn Wennerstrom, DNP, PMHNP-C
• Lance Aaron Wenzel
• Alexis Wernsman, APN
• Madeline Wernsman
• Dezzerae Westbrook
• John Franklin Whipps, DMD
• Kennah White
• Shae N Whitelow, BS, CADC
• Brooke Nicole Whittington, SLP

• Family Nurse Practitioner in Centralia, IL
• Providers in Centralia, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; 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.

Verify at the official NPI Registry.