Jennifer Uphoff

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085-004447 Issued in IL

Practice address

1505 Eastland Dr
Bloomington, IL 61701-3534

Phone

(309) 663-2100

Fax

(309) 663-8322

NPI assigned

Feb 13, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer Tillery Former name

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

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Saint Francis Medical Center

  dba Physical Medicine & Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Peoria, IL
  • NPI 1023062312
  Medicare reassignment
• St Joseph Medical Center

  dba OSFMG - Bloomington

  • Family Medicine Physician
  • Bloomington, IL
  • NPI 1871547414
  Medicare reassignment
• Saint Francis Medical Center

  dba Saint Francis Home Health

  • Home Health Agency
  • Peoria, IL
  • NPI 1346281425
  NPD
• Saint Francis Medical Center

  dba Saint Francis Medical Center Emergency Department

  • Emergency Medical Services (Emergency Medicine) Physician
  • Peoria, IL
  • NPI 1952351397
  NPD
• St Joseph Medical Center

  dba OSF Saint Joseph Medical Center

  • General Acute Care Hospital
  • Bloomington, IL
  • NPI 1619916806
  NPD
• St Joseph Medical Center

  dba OSF Saint Joseph Medical Center

  • Emergency Medicine Physician
  • Bloomington, IL
  • NPI 1659552859
  NPD
• Central PA Pharmacy LLC.

  dba patton pharmacy and v&s variety

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1487993390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013534",
            "telephone_number": "309-663-2100",
            "fax_number": "309-663-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 EASTLAND DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013534",
            "telephone_number": "309-663-2100",
            "fax_number": "309-663-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPHOFF",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-13",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-004447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "TILLERY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Samantha Uhe
• Nicole Uhlmann, LCSW
• Mark Steven Ulbrich, M.D.
• Jane Underwood
• Stephanie Unsworth, DC
• Urologic Surgery Associates, S.C.
• Janet Wintersteen Valdes, PT
• Tara Valentine
• Shelby Valladares
• Ricardo Vallejo, MD

• Physician Assistant in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.