Individual provider Active NPI

Janet Lea Patterson, MD

  • Developmental - Behavioral Pediatrics Physician
  • Springfield, IL
National Provider Identifier
1497720411
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
036-068728 Issued in IL
Practice address
301 N 8TH St
Suite Pav 3a
Springfield, IL 62701-1041
Phone
(217) 545-8000
Fax
(217) 545-4815
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036068728 IL
Developmental - Behavioral Pediatrics Physician 2080P0006X 036-068728 IL Primary

Addresses

Primary practice location

301 N 8TH St
Suite Pav 3a
Springfield, IL 62701-1041

Mailing address

301 N 8TH St
PO Box 19658
Springfield, IL 62701-1041
Phone (217) 545-8000

Other identifiers 1

IdentifierTypeStateIssuer
036068728MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address janetpatterson@siusm.allscriptsdirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-068728ILMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc Pediatrics Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: janetpatterson@siusm.allscriptsdirect.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1497720411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N 8TH ST",
            "address_2": "PO BOX 19658",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011041",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N 8TH ST",
            "address_2": "SUITE PAV 3A",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627011041",
            "telephone_number": "217-545-8000",
            "fax_number": "217-545-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JANET",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036068728",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "IL",
            "license": "036-068728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036068728",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "janetpatterson@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "301 N 8th St",
            "address_2": "Suite PAV 3A",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627011041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.