Jennifer Smidt

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209011426 Issued in IL

Practice address

411 Maxine Dr
Morton, IL 61550-2495

Phone

(309) 263-2411

NPI assigned

Apr 9, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Proctor Health SystemsGroup PAC ID 3476440173, 131 clinicians

Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Methodist Medical Center of IllinoisGroup PAC ID 1355259714, shared by 8 NPIs, 387 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
• Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Carle Health Care Incorporated

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947
  Medicare reassignment Care Compare group NPD
• Proctor Health Systems

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1134173917
  Medicare reassignment Care Compare group NPD
• Methodist Medical Center of Illinois

  • Family Medicine Physician
  • Peoria, IL
  • NPI 1184670663
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755

  Gerontology

  NPD
• Proctor Health Systems

  • Rural Health Clinic/Center
  • Princeville, IL
  • NPI 1356057301
  NPD
• Proctor Health Systems

  • Ambulatory Surgical Clinic/Center
  • Peoria, IL
  • NPI 1720223837
  NPD

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

• Methodist Medical Center of Illinois

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1164474755
  Care Compare affiliation
• Proctor Community Hospital

  • General Acute Care Hospital
  • Peoria, IL
  • NPI 1033116876
  Care Compare affiliation
• Proctor Community Hospital

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1134826894
  Care Compare affiliation

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397001600000",
    "number": "1538588298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 MAXINE DR",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 MAXINE DR",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502495",
            "telephone_number": "309-263-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMIDT",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2014-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209011426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David M Skillrud, MD
• Mackenzie Lynn Smalley, LCSW
• Smalltown Dental Kids LLC
• Smalltown Dental Morton LLC
• Smalltown Dental on Fourth LLC
• Peter Smidt, DDS
• Amanda Smith, IBCLC
• Dawn Anne Smith, LCPC
• Janelle Renee Blair Smith, DO
• Brian C Sommer, O.D.

• Gerontology Nurse Practitioner in Morton, IL
• Providers in Morton, IL by specialty
• Gerontology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.