Nicole M Beard, APN

Individual provider Active NPI Family Nurse Practitioner · Chatham, IL

NPI 1508569856 · NPPES record last updated May 2, 2023

Key facts

NPI
1508569856
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
209027331 (IL)
Practice address
101 E Plummer Blvd
Chatham, IL 62629-8047
Phone
(217) 588-2600
Fax
(217) 862-0202
NPI assigned
Mar 24, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Physician Services (161 clinicians)

Practice addresses (Care Compare)

101 E Plummer Blvd
Chatham, IL 62629-8047
Phone (217) 588-2600

Hospital & facility affiliations

  • Memorial Medical Center Hospital · Springfield, IL · CCN 140148

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100 (group)
Quality
71.79
Promoting interoperability
77
Improvement activities
40
Cost
75.71

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20230602002429 IL Practitioner - Nurse Practitioner 4183081300 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Physician Services Current Accepting new patients
Memorial Physician Services Current
since Apr 30, 2023
Accepting new patients
Memorial Physician Services Current
since Apr 30, 2023
Accepting new patients
Family Medical Center of Chatham, LLC Current Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

3132 Old Jacksonville Rd
Ste 110
Springfield, IL 62704
Phone (217) 588-2600

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209027331 IL Yes

Addresses

Primary practice location

101 E Plummer Blvd
Chatham, IL 62629-8047

Mailing address

PO Box 3428
Springfield, IL 62708-3428
Phone (217) 588-2600

Other identifiers

IdentifierTypeStateIssuer
041.431038OtherILRN

Other names

  • Nicole M Henderson Former name

Other providers in Chatham, IL

All providers in Chatham, IL · Family Nurse Practitioner in Illinois

Sources for this page

Verify at the official NPI Registry.