Individual provider Active NPI

Vanessa D Pratt, FNP

  • Nurse Practitioner
  • Columbia, IL
National Provider Identifier
1164462172
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209021640 Issued in IL
Practice address
1000 Eleven S Ste 1a
Columbia, IL 62236-1078
Phone
(618) 470-6020
Fax
(618) 470-6021
NPI assigned
Jun 7, 2006
Last updated
Sep 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209021640 IL Primary
Family Nurse Practitioner 363LF0000X 133125 MO
Family Nurse Practitioner 363LF0000X 209021640 IL

Addresses

Primary practice location

1000 Eleven S Ste 1a
Columbia, IL 62236-1078

Mailing address

PO Box 959203
Saint Louis, MO 63195-2106
Phone (618) 470-6020

Other practice location 1

10050 Kennerly Rd Ste 2400
Saint Louis, MO 63128-2106
Phone (314) 849-6066

Other identifiers 1

IdentifierTypeStateIssuer
425804838MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2 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
I20200929001361 IL Practitioner - Nurse Practitioner 1052378742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

1 Memorial Dr
Alton, IL 62002-6722
Phone (618) 463-7240

1000 Eleven S
Suite 1a
Columbia, IL 62236-1078
Phone (618) 463-8500

4000 N Illinois LN
Swansea, IL 62226-1969
Phone (618) 257-6380

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209021640ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Medical Group SC CurrentSince Jan 1, 2025 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Jan 1, 2025 Accepting new patients
Jesse D Helton Past Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

4 Memorial Dr
Ste 134
Alton, IL 62002
Phone (618) 607-1340

4500 Memorial Dr
Belleville, IL 62226
Phone (618) 233-7750

163 E Bethalto Dr
Bethalto, IL 62010
Phone (618) 433-6490

1000 Eleven S
Ste 1A
Columbia, IL 62236
Phone (618) 281-8400

2122 Troy Rd
Ste 130
Edwardsville, IL 62025
Phone (618) 692-9876

5213 Godfrey Rd
Ste 110
Godfrey, IL 62035
Phone (618) 619-3330

4000 N Illinois Ln
Swansea, IL 62226
Phone (618) 233-8130

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433

Organizations & group practices 3

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1164462172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 959203",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631952106",
            "telephone_number": "618-470-6020",
            "fax_number": "618-470-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ELEVEN S STE 1A",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361078",
            "telephone_number": "618-470-6020",
            "fax_number": "618-470-6021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10050 Kennerly Rd Ste 2400",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282106",
            "country_code": "US",
            "telephone_number": "314-849-6066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRATT",
        "first_name": "VANESSA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209021640",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "133125",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209021640",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425804838",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1000 Eleven S Ste 1A",
            "city": "Columbia",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622361078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, IL

Sources for this page

Verify at the official NPI Registry.