Alyssa Ann Dearth, MSN, APN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209010633 Issued in IL

Practice address

151 W High St Lowr Level
Morris, IL 60450-1407

Phone

(815) 705-1000

Fax

(815) 705-2709

NPI assigned

Aug 14, 2013

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642636800000",
    "number": "1376976365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SCHOOL ST STE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501207",
            "telephone_number": "815-941-9124",
            "fax_number": "815-941-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 W HIGH ST LOWR LEVEL",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501407",
            "telephone_number": "815-705-1000",
            "fax_number": "815-705-2709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Randall Rd",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601344200",
            "country_code": "US",
            "telephone_number": "630-232-0280",
            "fax_number": "630-232-3895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27240 W Saxony Dr Ste 203",
            "address_purpose": "LOCATION",
            "city": "Channahon",
            "state": "IL",
            "postal_code": "604101417",
            "country_code": "US",
            "telephone_number": "815-705-1000",
            "fax_number": "815-705-2709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEARTH",
        "first_name": "ALYSSA",
        "middle_name": "ANN",
        "credential": "MSN, APN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (GROUP PTAN)",
            "identifier": "206147",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE (INDIVIDUAL PTAN)",
            "identifier": "F400099927",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "209.010633",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Morris, IL
• Providers in Morris, 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 Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.