Mary E Eident, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.021969 Issued in IL

Practice address

311 W Fairchild St
Danville, IL 61832-3876

Phone

(217) 383-4501

NPI assigned

Sep 11, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Catholic Health Initiatives ColoradoGroup PAC ID 8022927342, 1,230 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uch-Memorial Health System Hospital, Colorado Springs, CO, CCN 060022

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Catholic Health Initiatives Colorado

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Colorado Springs, CO
  • NPI 1356783351
  Medicare reassignment Care Compare group NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group NPD
• Catholic Health Initiatives Colorado

  • Otolaryngology Physician
  • Lakewood, CO
  • NPI 1699039156
  NPD
• Catholic Health Initiatives Colorado

  • Orthopaedic Surgery Physician
  • Longmont, CO
  • NPI 1891675294
  NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Catholic Health Initiatives Colorado

  • Neurological Surgery Physician
  • Lakewood, CO
  • NPI 1205846664
  NPD (past)

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

• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1073172201
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1124518113
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1144397134
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1154030732
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Fountain, CO
  • NPI 1295225274
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1316506231
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1407532559
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1518526441
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1538958400
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1578053567
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1598324428
  Care Compare affiliation
• Uch-MHS

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1629746599
  Care Compare affiliation

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1154936672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W FAIRCHILD ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323876",
            "telephone_number": "217-383-4501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2864 S Circle Dr Ste 450",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809064170",
            "country_code": "US",
            "telephone_number": "719-776-8850",
            "fax_number": "719-776-8855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EIDENT",
        "first_name": "MARY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0997514-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209021969",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.021969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Richard W Elghammer, PH.D.
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• Family Nurse Practitioner in Danville, IL
• Providers in Danville, 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 Jul 18, 2022; 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.