Individual provider Active NPI

Sonya McKinney, APRN

  • Nurse Practitioner
  • Mount Vernon, IL
National Provider Identifier
1407221484
Registry record updated Dec 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.013632 Issued in IL
Practice address
209 Crossroads PL
Mount Vernon, IL 62864-6545
Phone
(618) 244-6222
Fax
(618) 244-7299
NPI assigned
Dec 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209.013632 IL Primary
Family Nurse Practitioner 363LF0000X 209013632 IL

Addresses

Primary practice location

209 Crossroads PL
Mount Vernon, IL 62864-6545

Mailing address

209 Crossroads PL
Mount Vernon, IL 62864-6545
Phone (618) 244-6222

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
I20160210000590 IL Practitioner - Nurse Practitioner 1658675707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4101 N Water Tower PL
Mount Vernon, IL 62864-6296
Phone (618) 244-4313

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.013632ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Crossroads Inc CurrentSince Jan 14, 2023 Accepting new patients
Deaconess Illinois Crossroads Inc CurrentSince Dec 6, 2022 Accepting new patients

Locations

4101 N Water Tower Pl
Mount Vernon, IL 62864
Phone (618) 244-4313

209 Crossroads Pl
Ste 120
Mount Vernon, IL 62864
Phone (618) 242-3119

209 Crossroads Pl
Mount Vernon, IL 62864
Phone (618) 242-4554

Interoperability endpoints

  • Direct secure messaging: smckinney423038@direct.deaconess.com
  • Direct secure messaging: sonya.mckinney.1@27782.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1407221484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 CROSSROADS PL",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646545",
            "telephone_number": "618-244-6222",
            "fax_number": "618-244-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 CROSSROADS PL",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646545",
            "telephone_number": "618-244-6222",
            "fax_number": "618-244-7299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINNEY",
        "first_name": "SONYA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.013632",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013632",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.