Individual provider Active NPI

Jenia R Heavens, FNP-C

  • Family Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1508255662
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
309.008084 Issued in IL
Practice address
12 N 64TH St
Belleville, IL 62223-3809
Phone
(618) 397-0900
NPI assigned
Jan 13, 2015
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 309.008084 IL Primary
Family Nurse Practitioner 363LF0000X 209012258 IL

Addresses

Primary practice location

12 N 64TH St
Belleville, IL 62223-3809

Mailing address

1003 Martin Luther King Dr
Bloomington, IL 61701-1429
Phone (888) 924-3786

Other practice location 1

2148 Vadalabene Dr
Maryville, IL 62062-5632
Phone (618) 877-4420

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
I20190125001305 IL Practitioner - Nurse Practitioner 3274819990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Chestnut Health Systems IncGroup PAC ID 1052393063, 31 clinicians

Practice addresses (Care Compare)

50 Northgate Industrial Dr
Granite City, IL 62040-6805
Phone (618) 877-4420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209012258ILMDFamily Nurse Practitioner
309.008084ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health Systems Inc. CurrentSince Dec 10, 2018 Accepting new patients
Chestnut Health Systems Inc CurrentSince Dec 10, 2018 Accepting new patients
Chestnut Health Systems, Inc Past Accepting new patients

Locations

12 N 64th St
Belleville, IL 62223
Phone (618) 397-0900

1003 Martin Luther King Dr
Bloomington, IL 61701
Phone (309) 827-6026

720 W Chestnut St
Bloomington, IL 61701
Phone (309) 557-1400

50 Northgate Industrial Dr
Granite City, IL 62040
Phone (618) 512-1919

2148 Vadalabene Dr
Maryville, IL 62062
Phone (618) 288-3100

Interoperability endpoints

  • Direct secure messaging: jenia.heavens@cfhc.eclinicaldirectplus.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1508255662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 MARTIN LUTHER KING DR",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617011429",
            "telephone_number": "888-924-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N 64TH ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622233809",
            "telephone_number": "618-397-0900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2148 Vadalabene Dr",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620625632",
            "country_code": "US",
            "telephone_number": "618-877-4420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEAVENS",
        "first_name": "JENIA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "309.008084",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012258",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.