Dana Marie Ruholl, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209031383 Issued in IL

Practice address

900 W Temple Ave Ste 208
Effingham, IL 62401-2187

Phone

(618) 332-0953

NPI assigned

Jan 9, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Illinois Healthcare Foundation IncGroup PAC ID 1456256874, 117 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Anthonys Memorial Hospital Hospital, Effingham, IL, CCN 140032
• Sarah Bush Lincoln Health Center Hospital, Mattoon, IL, CCN 140189

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dana.ruholl.1@9559.direct.athenahealth.com

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.

• Southern Illinois Healthcare Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Centreville, IL
  • NPI 1609813500
  Medicare reassignment Care Compare group NPD
• Southern Illinois Healthcare Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Effingham, IL
  • NPI 1154651776

  Nurse Practitioner

  NPD
• Southern Illinois Healthcare Foundation Inc

  • Federally Qualified Health Center (FQHC)
  • Waterloo, IL
  • NPI 1821813247
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  • General Acute Care Hospital
  • Effingham, IL
  • NPI 1306800602
  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  • Clinic/Center
  • Effingham, IL
  • NPI 1881214104

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1736380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1336959568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 GOOSE LAKE RD",
            "city": "SAUGET",
            "state": "IL",
            "postal_code": "622062822",
            "telephone_number": "618-332-0953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W TEMPLE AVE STE 208",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012187",
            "telephone_number": "618-332-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUHOLL",
        "first_name": "DANA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-09",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.420849",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.031383",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209031383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCE PRACTICE REGISTERED NURSE LICENSE",
            "identifier": "209.031383",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED PROFESSIONAL NURSE LICENSE",
            "identifier": "041.420849",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dana.ruholl.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "900 W Temple Ave Ste 208",
            "city": "Effingham",
            "state": "IL",
            "country_code": "US",
            "postal_code": "624012187",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Linda Ann Ross, PT
• Tal M Rozene, RPH
• Tina M Rozene, M.D.
• Ruben Boyajian, MD
• Amy Ruholl, RPH
• Jaime Ruiz Jr.
• Robert T Runde
• Hanna M Saba, MD
• Sammy Flynn Therapy Solutions Inc
• Sarah Buhnerkempe

• Family Nurse Practitioner in Effingham, IL
• Providers in Effingham, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; 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.

Verify at the official NPI Registry.