Individual provider Active NPI

Haley Christina Stephenson, NP

  • Nurse Practitioner
  • Herrin, IL
National Provider Identifier
1427804277
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209028726 Issued in IL
Practice address
405 Rushing Dr
Herrin, IL 62948-3730
Phone
(618) 993-3300
Fax
(618) 993-0262
NPI assigned
Apr 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209028726 IL Primary

Addresses

Primary practice location

405 Rushing Dr
Herrin, IL 62948-3730

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

117 E Clark St
Harrisburg, IL 62946-2702
Phone (618) 252-8625

Other practice location 2

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

Other practice location 3

502 W Saint Louis St Ste 4
West Frankfort, IL 62896-1968
Phone (618) 937-3400

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address hstephenson77660@sih.direct-ci.com
Direct Messaging Address hstephenson77660@sih.direct-ci.com
Direct Messaging Address hstephenson77660@sih.direct-ci.com
Direct Messaging Address hstephenson77660@sih.direct-ci.com

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
I20240723000467 IL Practitioner - Nurse Practitioner 9537605985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Logan Primary Care Service Corp.Group PAC ID 8628967064, 33 clinicians

Practice addresses (Care Compare)

405 Rushing Dr
Herrin, IL 62948-3730
Phone (618) 993-3300

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Aug 5, 2024 Accepting new patients

Locations

1239 E Main St
Carbondale, IL 62901

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

117 E Clark St
Harrisburg, IL 62946
Phone (618) 252-8625

405 Rushing Dr
Herrin, IL 62948
Phone (618) 993-3300

502 W Saint Louis St
Ste 4
West Frankfort, IL 62896
Phone (618) 937-3400

Interoperability endpoints

  • Direct secure messaging: hstephenson77660@sih.direct-ci.com

Organizations & group practices 1

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 3

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": "1713916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1427804277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 RUSHING DR",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483730",
            "telephone_number": "618-993-3300",
            "fax_number": "618-993-0262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 E Clark St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "IL",
            "postal_code": "629462702",
            "country_code": "US",
            "telephone_number": "618-252-8625",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 W Main St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011031",
            "country_code": "US",
            "telephone_number": "618-549-5361",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "502 W Saint Louis St Ste 4",
            "address_purpose": "LOCATION",
            "city": "West Frankfort",
            "state": "IL",
            "postal_code": "628961968",
            "country_code": "US",
            "telephone_number": "618-937-3400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENSON",
        "first_name": "HALEY",
        "middle_name": "CHRISTINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-24",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209028726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hstephenson77660@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 Rushing Dr",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hstephenson77660@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2601 W Main St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hstephenson77660@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "117 E Clark St",
            "city": "Harrisburg",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629462702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hstephenson77660@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "502 W Saint Louis St Ste 4",
            "city": "West Frankfort",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628961968",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

Verify at the official NPI Registry.