Individual provider Active NPI

Loralee Donnelly, FNP-BC

  • Family Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1174075147
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.014926 Issued in IL
Practice address
747 N Rutledge St FL 5
Springfield, IL 62702-6700
Phone
(217) 545-8000
Fax
(217) 545-7305
NPI assigned
Oct 26, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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 209.014926 IL Primary

Addresses

Primary practice location

747 N Rutledge St FL 5
Springfield, IL 62702-6700

Mailing address

PO Box 19665
Springfield, IL 62794-9665
Phone (217) 545-8000

Other practice location 1

751 N Rutledge St Lowr Level
Springfield, IL 62702-4968
Phone (217) 545-8000

Other practice location 2

301 N 8th St
Springfield, IL 62701
Phone (217) 545-8000

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
I20161222000676 IL Practitioner - Nurse Practitioner 7012298482 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons IncGroup PAC ID 2365352820, 316 clinicians

Practice addresses (Care Compare)

301 N 8TH St
Springfield, IL 62701-1041
Phone (217) 545-8000

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148
  • St Johns Hospital Hospital, Springfield, IL, CCN 140053
  • Taylorville Memorial Hospital Hospital, Taylorville, IL, CCN 141339
  • Carlinville Area Hospital Hospital, Carlinville, IL, CCN 141347

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.014926ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Jul 1, 2018 Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Jul 1, 2018 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

1770 E Lake Shore Dr
Ste 307
Decatur, IL 62521
Phone (217) 428-1500

751 N Rutledge St
Lowr
Springfield, IL 62702
Phone (217) 545-0182

747 N Rutledge St
Fl 5
Springfield, IL 62702
Phone (217) 545-3262

301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

400 N 9th St
Fl 4
Springfield, IL 62702

Interoperability endpoints

  • Direct secure messaging: loraleedonnelly@siusm.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

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": "1477440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1174075147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19665",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949665",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 N RUTLEDGE ST FL 5",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627026700",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 N Rutledge St Lowr Level",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627024968",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7169",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 N 8th St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "62701",
            "country_code": "US",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-7305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "LORALEE",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-26",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.014926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.