Individual provider Active NPI

Tasha Rickermann Vallee, FNP-BC

  • Family Nurse Practitioner
  • Quincy, IL
National Provider Identifier
1407198476
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
277001714 Issued in IL
Practice address
1915 Jefferson St
Quincy, IL 62301-5652
Phone
(217) 577-2992
Fax
(217) 214-6785
NPI assigned
Mar 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2006019144 MO
Family Nurse Practitioner 363LF0000X 2013006672 MO
Family Nurse Practitioner 363LF0000X 209010408 IL
Family Nurse Practitioner 363LF0000X 277001714 IL Primary

Addresses

Primary practice location

1915 Jefferson St
Quincy, IL 62301-5652

Mailing address

1915 Jefferson St
Quincy, IL 62301-5652
Phone (217) 577-2992

Other names 1

  • Tasha D. Rickermann Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL 01/01/2019 Direct Quincy Physicians & Surgeons Clinic, PLLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 31, 2022 through Jan 31, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006019144MOMDRegistered Nurse
277001714ILMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1407198476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 JEFFERSON ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623015652",
            "telephone_number": "217-577-2992",
            "fax_number": "217-214-6785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 JEFFERSON ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623015652",
            "telephone_number": "217-577-2992",
            "fax_number": "217-214-6785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLEE",
        "first_name": "TASHA",
        "middle_name": "RICKERMANN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-18",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2006019144",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2013006672",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209010408",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277001714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "01/01/2019",
            "affiliation": "Y",
            "endpointDescription": "Left the organization",
            "affiliationName": "Quincy Physicians & Surgeons Clinic, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "109 Buckhorn Rd",
            "city": "MT Sterling",
            "state": "IL",
            "country_code": "US",
            "postal_code": "623531403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TASHA",
            "last_name": "RICKERMANN",
            "middle_name": "D.",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.