Stefanie Poettker

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209.033426 Issued in IL

Practice address

130 S Lincoln Blvd
Centralia, IL 62801-3654

Phone

(618) 993-0404

NPI assigned

Oct 2, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Orthopedic Associates SCGroup PAC ID 8921095514, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Herrin Hospital Hospital, Herrin, IL, CCN 140011

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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 Orthopedic Associates SC

  • Orthopaedic Surgery Physician
  • Herrin, IL
  • NPI 1396792412
  Medicare reassignment Care Compare group NPD
• Deaconess Illinois Specialty Clinic, Inc.

  • Surgery Physician
  • Marion, IL
  • NPI 1972210235
  Medicare reassignment
• Deaconess Illinois Specialty Clinic, Inc.

  • Hospitalist Physician
  • Anna, IL
  • NPI 1225858251

  Nurse Practitioner

  NPD
• Deaconess Illinois Specialty Clinic, Inc.

  • Family Medicine Physician
  • Anna, IL
  • NPI 1689381162

  Nurse Practitioner

  NPD

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

• Southern Illinois Hospital Services

  • General Acute Care Hospital
  • Herrin, IL
  • NPI 1528158573
  Care Compare affiliation

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

{
    "created_epoch": "1759363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1376417253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15487 E TOLLE RD",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628648364",
            "telephone_number": "618-204-2344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S LINCOLN BLVD",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013654",
            "telephone_number": "618-993-0404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 W Saint Louis St",
            "address_purpose": "LOCATION",
            "city": "West Frankfort",
            "state": "IL",
            "postal_code": "628962037",
            "country_code": "US",
            "telephone_number": "618-993-0404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POETTKER",
        "first_name": "STEFANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-02",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.033426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janna Pierce
• Pinckneyville Healthcare Center LLC
• Stephanie Pitt, RDN, LPC
• Jessica Plant
• Shaun James Poehler, D.C.
• Kaleigh Price
• Progressive Life Counseling LLC
• Emily Beth Purcell, RN, BSN, OCN, MBA
• Raccoon C S D 1
• William Thomas Radcliffe

• Nurse Practitioner in Centralia, IL
• Providers in Centralia, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.