Individual provider Active NPI

Nina Renee Seplak, APN

  • Family Nurse Practitioner
  • Seneca, IL
National Provider Identifier
1497286645
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2090150480 Issued in IL
Practice address
271 N Main St
Seneca, IL 61360-9323
Phone
(815) 357-8511
Fax
(815) 357-1238
NPI assigned
Mar 21, 2017
Last updated
Apr 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2090150480 IL Primary

Addresses

Primary practice location

271 N Main St
Seneca, IL 61360-9323

Mailing address

725 School St Ste a
Morris, IL 60450-1207
Phone (815) 941-9124

Other practice location 1

200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-5841

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
I20200501000133 IL Practitioner - Nurse Practitioner 5193080463 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
Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

271 N Main St
Seneca, IL 61360-9323
Phone (815) 357-8511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2090150480ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital CurrentSince May 18, 2020 Accepting new patients
Morris Hospital Current Accepting new patients
Morris Hospital CurrentSince May 18, 2020 Accepting new patients
Morris Hospital Current Accepting new patients

Locations

389 E Main St
Braidwood, IL 60408
Phone (815) 458-2532

27240 W Saxony Dr
Ste 201
Channahon, IL 60410
Phone (815) 467-1518

150 W High St
Morris, IL 60450
Phone (815) 942-2129

725 School St
Ste A
Morris, IL 60450

271 N Main St
Seneca, IL 61360
Phone (815) 357-8511

Interoperability endpoints

  • Direct secure messaging: nina.seplak.1@14307.direct.athenahealth.com
  • Direct secure messaging: nina.seplak@direct-address.org

Organizations & group practices 4

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 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": "1490054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1497286645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 SCHOOL ST STE A",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604501207",
            "telephone_number": "815-941-9124",
            "fax_number": "815-941-4363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 N MAIN ST",
            "city": "SENECA",
            "state": "IL",
            "postal_code": "613609323",
            "telephone_number": "815-357-8511",
            "fax_number": "815-357-1238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 E Fairman Ave",
            "address_purpose": "LOCATION",
            "city": "Watseka",
            "state": "IL",
            "postal_code": "609701644",
            "country_code": "US",
            "telephone_number": "815-432-5841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEPLAK",
        "first_name": "NINA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-21",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "2090150480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seneca, IL

Sources for this page

Verify at the official NPI Registry.