Individual provider Active NPI

Mary C. Littlejohn, APN

  • Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1255779955
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209010179 Issued in IL
Practice address
130 Lincoln Court Place
Belleville, IL 62221-5372
Phone
(618) 257-2029
Fax
(618) 235-5371
NPI assigned
Jun 5, 2013
Last updated
Sep 27, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209010179 IL Primary
Adult Health Nurse Practitioner 363LA2200X 209010179 IL

Addresses

Primary practice location

130 Lincoln Court Place
Belleville, IL 62221-5372

Mailing address

130 Lincoln Court Place
Belleville, IL 62221-5372
Phone (618) 257-2029

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
I20140421000127 IL Practitioner - Nurse Practitioner 3577795806 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Anthonys Way
Alton, IL 62002-4568
Phone (618) 465-2571

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

12866 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2658

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.63
Improvement activities
40
Cost
81.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209010179ILMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-Illinois Hospitalists, LLP CurrentSince May 1, 2016 Accepting new patients
Cep America - Illinois SNF LLP CurrentSince Oct 1, 2016 Accepting new patients
Cep America - Illinois SNF, LLP CurrentSince Oct 1, 2016 Accepting new patients
Cep America-Illinois Hospitalists CurrentSince May 1, 2016 Accepting new patients
Cep America-Illinois Hospitalists, LLP Current Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 900-3125

1021 W E St
Belleville, IL 62220
Phone (618) 233-2095

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

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1370390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506470400000",
    "number": "1255779955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 LINCOLN COURT PLACE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215372",
            "telephone_number": "618-257-2029",
            "fax_number": "618-235-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LINCOLN COURT PLACE",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622215372",
            "telephone_number": "618-257-2029",
            "fax_number": "618-235-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLEJOHN",
        "first_name": "MARY",
        "middle_name": "C.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-05",
        "last_updated": "2017-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209010179",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209010179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.