Individual provider Active NPI

Wayland J Mutter, RN

  • Nurse Practitioner
  • Quincy, IL
National Provider Identifier
1447769724
Registry record updated Oct 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209017279 Issued in IL
Practice address
1005 Broadway St
Quincy, IL 62301-2834
Phone
(217) 223-1200
Fax
(217) 277-8988
NPI assigned
Sep 29, 2017
Last updated
Oct 27, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 041326848 IL
Acute Care Nurse Practitioner 363LA2100X 209017279 IL
Nurse Practitioner 363L00000X 209017279 IL Primary

Addresses

Primary practice location

1005 Broadway St
Quincy, IL 62301-2834

Mailing address

1025 Maine St
Quincy, IL 62301-4038
Phone (217) 222-6550

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wmutter31751@blessing.medalliesdirect.net Direct

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
I20180320001919 IL Practitioner - Nurse Practitioner 3476815010 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041326848ILMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Blessing Hospital CurrentSince Jul 24, 2019 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC CurrentSince Feb 12, 2018 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Blessing Hospital CurrentSince Jul 24, 2019 Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Current Accepting new patients
Quincy Physicians & Surgeons Clinic, PLLC Nurse Practitioner CurrentSince Feb 12, 2018 Accepting new patients

Locations

1005 Broadway St
Quincy, IL 62301

1025 Maine St
Quincy, IL 62301
Phone 21722265503163

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod
  • Direct secure messaging: wmutter610360@direct.unitypoint.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793059200000",
    "number": "1447769724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014038",
            "telephone_number": "217-222-6550",
            "fax_number": "217-277-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-1200",
            "fax_number": "217-277-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTTER",
        "first_name": "WAYLAND",
        "middle_name": "J",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2026-10-27",
        "certification_date": "2026-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "IL",
            "license": "041326848",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209017279",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209017279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wmutter31751@blessing.medalliesdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1005 Broadway St",
            "city": "Quincy",
            "state": "IL",
            "country_code": "US",
            "postal_code": "623012834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.