Ruth M Fiedler-Eaton, APN
Individual provider Active NPI Family Nurse Practitioner · Erie, IL
NPI 1396740148 · NPPES record last updated Sep 14, 2023
Key facts
- NPI
- 1396740148
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209-000647 (IL)
- Practice address
- 530 12TH St
Erie, IL 61250-9461 - Phone
- (309) 659-2215
- Fax
- (309) 659-2006
- NPI assigned
- Jun 17, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|---|
| I20061003000159 | IL | Practitioner - Nurse Practitioner | 2264437862 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-000647 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morrison Community Hospital District | Current | Accepting new patients | |
| Morrison Community Hospital District | Past | Accepting new patients |
Locations
303 N Jackson St
Morrison, IL 61270
Phone (815) 772-4003
Interoperability endpoints
- ruthfiedler-eaton@mchospital.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209-000647 | IL | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 049734 | Other | HEALTH ALLIANCE | |
| IL0129 | Other | JOHN DEERE HEALTH PLAN | |
| 149294 | Other | IOWA HEALTH SOLUTIONS | |
| 4796890014 | Other | DMERC |
Other names
- Ruth M Fiedler
Other providers in Erie, IL
- Erie Cusd 1
- Erie Fire Protection District
- Genesis Health System
- Local Health Inc
- Amanda Misfeldt
- Morrison Community Hospital District
- Quality Care Partners LLC
All providers in Erie, 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 Sep 14, 2023. 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).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.