Echo Amanda Renee Redman, APRN
Individual provider Active NPI Nurse Practitioner · Clinton, IL
NPI 1194458976 · NPPES record last updated Aug 25, 2022
Key facts
- NPI
- 1194458976
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 209.025730 (IL)
- Practice address
- 1231 Kleemann Dr
Clinton, IL 61727-2635 - Phone
- (217) 935-5022
- Fax
- (217) 935-7692
- NPI assigned
- Jul 8, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Saint James Hospital
Practice addresses (Care Compare)
1231 Kleemann Dr
Clinton, IL 61727-2633
Phone (217) 935-5022
2500 W Reynolds St
Pontiac, IL 61764-9774
Phone (815) 842-2828
Hospital & facility affiliations
- St Joseph Medical Center
- Warner Hospital and Health Services
- Saint James Hospital
- Decatur Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221004003709 | IL | Practitioner - Nurse Practitioner | 6709262348 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.413640 | IL | MD | Registered Nurse |
| 209.025730 | IL | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint James Hospital | Current |
Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients | |
| Saint James Hospital | Current |
Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients | |
| Saint James Hospital | Nurse Practitioner | Past | Accepting new patients |
Locations
1231 Kleemann Dr
Clinton, IL 61727
Phone (217) 935-5022
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041.413640 | IL | |
| Nurse Practitioner | 363L00000X | 209.025730 | IL | Yes |
Addresses
Primary practice location
1231 Kleemann Dr
Clinton, IL 61727-2635
Mailing address
919 N George St
Clinton, IL 61727-1122
Phone (217) 433-3969
Other providers in Clinton, IL
- Chelsey Shantelle Morris
- Paramedic Services of Illinois Inc,
- Danna Elizabeth Powers
- Prescription Shoppe of Clinton Inc
- Daren J. Rauch
- Residential Alternatives of Illinois Inc
- Residential Alternatives of Illinois Inc
- Ariel Marie Rhoades
- Gary J Riegel
- Elsie Rodriguez
All providers in Clinton, IL · Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.