Individual provider Active NPI

Brittany N Anderson, APN

  • Nurse Practitioner
  • Champaign, IL
National Provider Identifier
1255895108
Registry record updated Jan 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209018713 Issued in IL
Practice address
2043 S Neil St
Champaign, IL 61820-7219
Phone
(217) 337-3852
NPI assigned
Jan 24, 2019
Last updated
Jan 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209018713 IL Primary

Addresses

Primary practice location

2043 S Neil St
Champaign, IL 61820-7219

Mailing address

2710 N Prospect Ave
Champaign, IL 61822-1298
Phone (217) 337-3852

Other practice location 1

2710 N Prospect Ave
Champaign, IL 61822-1298
Phone (217) 337-3852

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
I20190305000563 IL Practitioner - Nurse Practitioner 5193064400 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Mar 1, 2019 Accepting new patients

Locations

2043 S Neil St
Champaign, IL 61820
Phone (217) 337-3852

2710 N Prospect Ave
Champaign, IL 61822
Phone (217) 337-3852

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579132800000",
    "number": "1255895108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 N PROSPECT AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221298",
            "telephone_number": "217-337-3852",
            "fax_number": "217-337-3853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 S NEIL ST",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207219",
            "telephone_number": "217-337-3852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2710 N Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618221298",
            "country_code": "US",
            "telephone_number": "217-337-3852",
            "fax_number": "217-337-3853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "BRITTANY",
        "middle_name": "N",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-24",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209018713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

Verify at the official NPI Registry.