Individual provider Active NPI

Janice Marea Pierson, M.D.

  • Internal Medicine Physician
  • Palos Heights, IL
National Provider Identifier
1255329546
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036088112 Issued in IL
Practice address
12800 S Ridgeland Ave
Palos Heights, IL 60463-2390
Phone
(708) 293-7004
Fax
(773) 694-5230
NPI assigned
Oct 11, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 01046761A IN
Internal Medicine Physician 207R00000X 036088112 IL Primary

Addresses

Primary practice location

12800 S Ridgeland Ave
Palos Heights, IL 60463-2390

Mailing address

12800 S Ridgeland Ave
Palos Heights, IL 60463-2390
Phone (708) 293-7004

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address jpierson@immpactnow.com Direct
Direct Messaging Address jpierson@immpactnow.com Direct
Direct Messaging Address jpierson278514@direct.myadvocateaurora.org Direct
FHIR URL https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040723000752 IL Practitioner - Internal Medicine 0941288229 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01046761AINMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
A & S Divine Healthcare Services PLLC CurrentSince Oct 1, 2021 Accepting new patients
Asad Zaman MD SC Internal Medicine CurrentSince Mar 1, 2019 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

1477 Ring Rd
Calumet City, IL 60409
Phone (708) 868-3309

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

6700 167th St
Ste 5
Tinley Park, IL 60477
Phone (708) 429-3700

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640736000000",
    "number": "1255329546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 S RIDGELAND AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632390",
            "telephone_number": "708-293-7004",
            "fax_number": "773-694-5230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 S RIDGELAND AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604632390",
            "telephone_number": "708-293-7004",
            "fax_number": "773-694-5230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERSON",
        "first_name": "JANICE",
        "middle_name": "MAREA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-11",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01046761A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036088112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpierson@immpactnow.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12800 S Ridgeland Ave",
            "city": "Palos Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604632390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpierson@immpactnow.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12800 S Ridgeland Ave",
            "city": "Palos Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604632390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpierson278514@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12800 S Ridgeland Ave",
            "city": "Palos Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604632390",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "12800 S Ridgeland Ave",
            "city": "Palos Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604632390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.