Individual provider Active NPI

Ruth M Fiedler-Eaton, APN

  • Family Nurse Practitioner
  • Erie, IL
National Provider Identifier
1396740148
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-000647 Issued in IL
Practice address
530 12TH St
Erie, IL 61250-9461
Phone
(309) 659-2215
Fax
(309) 659-2006
NPI assigned
Jun 17, 2005
Last updated
Sep 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209-000647 IL Primary

Addresses

Primary practice location

530 12TH St
Erie, IL 61250-9461

Mailing address

865 Lincoln Rd
Ste L10
Bettendorf, IA 52722-4159
Phone (563) 355-9191

Other names 1

  • Ruth M Fiedler Former name

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
I20061003000159 IL Practitioner - Nurse Practitioner 2264437862 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-000647ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Morrison Community Hospital District Current Accepting new patients
CGH Medical Center Past Accepting new patients

Locations

303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003

Interoperability endpoints

  • Direct secure messaging: ruthfiedler-eaton@mchospital.medalliesdirect.net

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": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1396740148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "865 LINCOLN RD",
            "address_2": "STE L10",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527224159",
            "telephone_number": "563-355-9191",
            "fax_number": "563-355-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 12TH ST",
            "city": "ERIE",
            "state": "IL",
            "postal_code": "612509461",
            "telephone_number": "309-659-2215",
            "fax_number": "309-659-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIEDLER-EATON",
        "first_name": "RUTH",
        "middle_name": "M",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-17",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-000647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUTH",
            "last_name": "FIEDLER",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Erie, IL

Sources for this page

Verify at the official NPI Registry.