Individual provider Active NPI

John Nichols, FNP

  • Family Nurse Practitioner
  • Mattoon, IL
National Provider Identifier
1437666294
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015936 Issued in IL
Practice address
1000 Health Center Dr
Mattoon, IL 61938
Phone
(217) 238-4325
Fax
(217) 238-4290
NPI assigned
Jan 2, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209015936 IL
Hospitalist Physician 208M00000X 209015936 IL
Family Nurse Practitioner 363LF0000X 2017028743 MO
Family Nurse Practitioner 363LF0000X 209015936 IL Primary

Addresses

Primary practice location

1000 Health Center Dr
Mattoon, IL 61938

Mailing address

PO Box 372
Mattoon, IL 61938-0372

Other practice location 1

1000 Health Center Dr
Mattoon, IL 61938-9253
Phone (217) 258-2551

Other practice location 2

78 Bert Ave
East Alton, IL 62024-1725
Phone (217) 246-4923

Other practice location 3

78 Bert Ave
East Alton, IL 62024-1725
Phone (217) 246-4923

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
I20180714000155 IL Practitioner - Nurse Practitioner 4486901980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Practice addresses (Care Compare)

1000 Health Ctr Dr
Mattoon, IL 61938-4644
Phone (217) 258-2525

Hospital & facility affiliations

  • Sarah Bush Lincoln Health Center Hospital, Mattoon, IL, CCN 140189

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209015936ILMDHospitalist Physician
2017028743MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince May 22, 2018 Accepting new patients

Locations

1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1000 Health Center Dr
Ste H
Mattoon, IL 61938

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

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 1

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": "1514851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741651200000",
    "number": "1437666294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HEALTH CENTER DR",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "61938",
            "telephone_number": "217-238-4325",
            "fax_number": "217-238-4290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Health Center Dr",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619389253",
            "country_code": "US",
            "telephone_number": "217-258-2551",
            "fax_number": "217-258-2256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "78 Bert Ave",
            "address_purpose": "LOCATION",
            "city": "East Alton",
            "state": "IL",
            "postal_code": "620241725",
            "country_code": "US",
            "telephone_number": "217-246-4923",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "78 Bert Ave",
            "address_purpose": "LOCATION",
            "city": "East Alton",
            "state": "IL",
            "postal_code": "620241725",
            "country_code": "US",
            "telephone_number": "217-246-4923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "JOHN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-01-02",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209015936",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "209015936",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2017028743",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.