Benjamin Allen Morelock
Individual provider Active NPI Acute Care Nurse Practitioner · Quincy, IL
NPI 1407435241 · NPPES record last updated Apr 7, 2021
Key facts
- NPI
- 1407435241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 209023125 (IL)
- Practice address
- 1005 Broadway St
Quincy, IL 62301-2834 - Phone
- (217) 223-1200
- NPI assigned
- Apr 7, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 21
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Blessing Hospital
Practice addresses (Care Compare)
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400
Hospital & facility affiliations
- Blessing Hospital
- Memorial Hospital
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 |
|---|---|---|---|---|
| I20210513000889 | IL | Practitioner - Nurse Practitioner | 9133538606 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blessing Hospital | Multi-Specialty | Current |
Accepting new patients |
| Blessing Hospital | Current |
Accepting new patients | |
| Blessing Hospital | Current | Accepting new patients |
Locations
1005 Broadway St
Quincy, IL 62301
Interoperability endpoints
- https://fhir.blessinghospital.com/R4/open-Prod
- benjaminmorelock@blessing.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Nurse Practitioner | 363LC0200X | 209023125 | IL | |
| Acute Care Nurse Practitioner |
363LA2100X | 209023125 | IL | Yes |
Addresses
Primary practice location
1005 Broadway St
Quincy, IL 62301-2834
Mailing address
1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-1200
Other providers in Quincy, IL
- Lacy D Moore
- Mandy Moore
- Sarah M Moore
- Taylor J. Moore
- Travis C Moore
- Lorraine Morgan
- Timothy J Morgan
- Sean P Moroze
- Reuben P Morris
- Ricky Morrison
All providers in Quincy, IL · Acute Care 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 Apr 7, 2021. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.