Individual provider Active NPI

Alexa Wurm, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, IL
National Provider Identifier
1508605197
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.031183 Issued in IL
Practice address
1201 Ricker Rd
Salem, IL 62881-4263
Phone
(618) 975-4621
NPI assigned
May 22, 2024
Last updated
Dec 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041508434 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.031183 IL Primary

Addresses

Primary practice location

1201 Ricker Rd
Salem, IL 62881-4263

Mailing address

19708 US Highway 50
Carlyle, IL 62231-2328
Phone (618) 975-4621

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
I20250409001223 IL Practitioner - Nurse Practitioner 1153845326 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Township HospitalGroup PAC ID 0840195277, 26 clinicians
Community Resource Center IncGroup PAC ID 8224050638, 4 clinicians

Practice addresses (Care Compare)

1201 Ricker Rd
Salem, IL 62881-4263
Phone 61854831948188

1321 W Whittaker St
STH Family Health Care Center
Salem, IL 62881-2013
Phone 61854831948188

904 E Martin Luther King Dr
Centralia, IL 62801-3056
Phone (618) 533-1391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041508434ILMDRegistered Nurse
209.031183ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Township Hospital CurrentSince Aug 11, 2025 Accepting new patients
Community Resource Center Inc. CurrentSince Apr 1, 2025 Accepting new patients
Community Resource Center Inc. CurrentSince Apr 1, 2025 Accepting new patients
Salem Township Hospital CurrentSince Aug 11, 2025 Accepting new patients
Salem Township Hospital Past Accepting new patients

Locations

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

421 W Main St
Vandalia, IL 62471
Phone (618) 283-4229

Organizations & group practices 5

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": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1508605197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19708 US HIGHWAY 50",
            "city": "CARLYLE",
            "state": "IL",
            "postal_code": "622312328",
            "telephone_number": "618-975-4621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 RICKER RD",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "628814263",
            "telephone_number": "618-975-4621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURM",
        "first_name": "ALEXA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041508434",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.031183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IL

Sources for this page

Verify at the official NPI Registry.