Danielle L. Bogue, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Highland, IL
NPI 1295062537 · NPPES record last updated Aug 28, 2024
Key facts
- NPI
- 1295062537
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209-007734 (IL)
- Practice address
- 1212 Broadway
Highland, IL 62249-1960 - Phone
- (618) 651-0022
- Fax
- (618) 651-0023
- NPI assigned
- Nov 6, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Anderson Medical Group LLC
Practice addresses (Care Compare)
1212 Broadway
Highland, IL 62249-1960
Phone (618) 651-0022
Hospital & facility affiliations
- Anderson Hospital
- Community Hospital of Staunton
- St Josephs Hospital
- St Joseph'S Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 74.76 of 100
- Quality
- 54.98
- Promoting interoperability
- 85
- Improvement activities
- 40
- Cost
- 73.39
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 |
|---|---|---|---|---|
| I20110216000107 | IL | Practitioner - Nurse Practitioner | 2466632930 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-007734 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ahs Il Medical Group LLC | Current |
Accepting new patients | |
| Anderson Medical Group, LLC | Current |
Accepting new patients | |
| Granite City Physicians Corp | Past | Accepting new patients | |
| St Alexius Emergency Physicians LLC | Past | Accepting new patients |
Locations
1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870
1000 Eleven S
Ste 1A
Columbia, IL 62236
Phone (618) 281-8400
4273 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-2297
2044 Madison Ave
Ste 27
Granite City, IL 62040
Phone (618) 451-0700
2100 Madison Ave
Granite City, IL 62040
Phone (618) 798-3000
1212 Broadway
Highland, IL 62249
Phone (618) 651-0022
6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405
8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500
619 Edwardsville Rd
Troy, IL 62294
Phone (618) 667-1200
Interoperability endpoints
- dbogue@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209-007734 | IL | Yes |
Addresses
Primary practice location
1212 Broadway
Highland, IL 62249-1960
Mailing address
6810 State Route 162
Box 215
Maryville, IL 62062
Phone (618) 391-6495
Other names
- Danielle L. Avett
Other providers in Highland, IL
- Best Foot Forward Corp
- Samantha Beverley
- Lynn D Billhartz
- Jill Marie Bloemker
- Larry L Boehler
- Bonnie Senner MSW LTD
- Jeremy S Bowen
- Kennedy Nicole Brauer
- Brilliant Baby OT PLLC
- Amy Lynn Britt
All providers in Highland, IL · Family 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 28, 2024. 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.