Active NPI
Haleigh Ranae Nicholson
- Family Nurse Practitioner
- Danville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209022381
- Practice address
- 3653 N. Vermilion Street
Danville, IL 61832 - Phone
- (217) 554-6827
- NPI assigned
- Feb 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209022381 | IL | Primary |
Addresses
Primary practice location
3653 N. Vermilion Street
Danville, IL 61832
Mailing address
615 S Oakwood St
Oakwood, IL 61858-9571
Phone (217) 474-6165
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210331001140 | IL | Practitioner - Nurse Practitioner | 0345657706 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
508 Iaa Dr
Bloomington, IL 61701-2216
Phone (309) 451-2080
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Saint Francis Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients |
Locations
3653 N Vermilion St
Danville, IL 61832
Phone (217) 554-6827
3679 N Vermilion St
Danville, IL 61832
Phone (217) 213-6264
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1205429503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 S OAKWOOD ST",
"city": "OAKWOOD",
"state": "IL",
"postal_code": "618589571",
"telephone_number": "217-474-6165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3653 N. VERMILION STREET",
"city": "DANVILLE",
"state": "IL",
"postal_code": "61832",
"telephone_number": "217-554-6827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLSON",
"first_name": "HALEIGH",
"middle_name": "RANAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-02-17",
"last_updated": "2021-03-11",
"certification_date": "2021-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209022381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Danville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.