Individual provider Active NPI

Catherine Durbin, APN

  • Acute Care Nurse Practitioner
  • Salem, IL
National Provider Identifier
1548664170
Registry record updated Oct 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209011964 Issued in IL
Practice address
518 South Broadway
Salem, IL 62881
Phone
(618) 548-8119
Fax
(618) 548-3417
NPI assigned
Oct 10, 2014
Last updated
Oct 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209011964 IL Primary
Family Nurse Practitioner 363LF0000X 209011964 IL

Addresses

Primary practice location

518 South Broadway
Salem, IL 62881

Mailing address

PO Box 99
Irvington, IL 62848-0099
Phone (618) 780-2849

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
I20150303000203 IL Practitioner - Nurse Practitioner 1456249416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salem Township HospitalGroup PAC ID 0840195277, 26 clinicians

Practice addresses (Care Compare)

1201 Ricker Rd
Salem, IL 62881-4263
Phone 61854831948188

1321 W Whittaker St
Salem, IL 62881-2013
Phone (618) 548-6644

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209011964ILMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Township Hospital CurrentSince Jan 30, 2019 Accepting new patients
Midwest Emergency Good Samaritan, Inc CurrentSince Jun 1, 2016 Accepting new patients
Salem Township Hospital CurrentSince Jan 30, 2019 Accepting new patients
Salem Township Hospital Past Accepting new patients
Salem Township Hospital Past Accepting new patients

Locations

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

605 N 12th St
Mount Vernon, IL 62864
Phone (618) 241-2200

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

1321 W Whittaker St
Salem, IL 62881
Phone (618) 548-0200

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1412899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412899200000",
    "number": "1548664170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "IRVINGTON",
            "state": "IL",
            "postal_code": "628480099",
            "telephone_number": "618-780-2849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 SOUTH BROADWAY",
            "city": "SALEM",
            "state": "IL",
            "postal_code": "62881",
            "telephone_number": "618-548-8119",
            "fax_number": "618-548-3417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURBIN",
        "first_name": "CATHERINE",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-10",
        "last_updated": "2014-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209011964",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011964",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, IL

Sources for this page

Verify at the official NPI Registry.