NPIMap

Individual provider Active NPI

Jana Tull, APN

  • Family Nurse Practitioner
  • Centralia, IL
National Provider Identifier
1588105654
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.015709 Issued in IL
Practice address
400 N Pleasant Ave
Centralia, IL 62801-3056
Phone
(618) 436-8000
NPI assigned
Mar 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.015709 IL Primary

Addresses

Primary practice location

400 N Pleasant Ave
Centralia, IL 62801-3056

Mailing address

561 W Alton St
Nashville, IL 62263-1370
Phone (618) 436-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170328002707 IL Practitioner - Nurse Practitioner 0446535793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1307 E McCord St
Centralia, IL 62801-3610
Phone (618) 899-9200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
92.55
Promoting interoperability
100
Improvement activities
40
Cost
79.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.015709ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Surgical Technology, LLC CurrentSince Aug 26, 2024 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Mar 12, 2017 Accepting new patients
Advanced Surgical Technology, LLC CurrentSince Aug 26, 2024 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Mar 12, 2017 Accepting new patients
St. Mary's Hospital, Centralia, Illinois Current Accepting new patients

Locations

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155

28 N Main St
Hoyleton, IL 62803
Phone (618) 791-2489

1145 Corporate Lake Dr
Saint Louis, MO 63132
Phone (314) 989-6189

Interoperability endpoints

  • Direct secure messaging: jtull80478@direct-ehr-ssmhc.com

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1588105654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 W ALTON ST",
            "city": "NASHVILLE",
            "state": "IL",
            "postal_code": "622631370",
            "telephone_number": "618-436-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PLEASANT AVE",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013056",
            "telephone_number": "618-436-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULL",
        "first_name": "JANA",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.015709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, IL

Sources for this page

Verify at the official NPI Registry.