Individual provider Active NPI

Beth Ann Denmon, FNP

  • Family Nurse Practitioner
  • Edwardsville, IL
National Provider Identifier
1609304401
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209015530 Issued in IL
Practice address
6616 Center Grove Rd.
Edwardsville, IL 62025
Phone
(618) 659-1599
Fax
(618) 659-1597
NPI assigned
May 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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 209015530 IL Primary

Addresses

Primary practice location

6616 Center Grove Rd.
Edwardsville, IL 62025

Mailing address

6810 State Route 162 Box 215
Maryville, IL 62062-8501
Phone (618) 391-6405

Other identifiers 1

IdentifierTypeStateIssuer
14017183OtherCAQH

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
I20170714001370 IL Practitioner - Nurse Practitioner 9537439187 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
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

2236 Vadalabene Dr
Suite 2
Maryville, IL 62062-5842
Phone (618) 391-5540

Hospital & facility affiliations

  • Anderson Home Health Services Home health agency, Maryville, IL, CCN 147420
  • Anderson Hospital Hospital, Maryville, IL, CCN 140289

Merit-based Incentive Payment System (MIPS)

Final score
74.76 of 100Reported as group
Quality
54.98
Promoting interoperability
85
Improvement activities
40
Cost
73.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209015530ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbe Senior Medical Illinois PC CurrentSince Mar 1, 2023 Accepting new patients
Anderson Medical Group, LLC CurrentSince May 30, 2017 Accepting new patients
Central Illinois Radiological Associates, LTD. Past Accepting new patients

Locations

225 W Washington St
Ste 1700
Chicago, IL 60606
Phone (234) 200-4220

225 W Washington St
Ste 1500
Chicago, IL 60606
Phone (312) 776-2422

6616 Center Grove Rd
Edwardsville, IL 62025
Phone (618) 659-1599

3417 Anderson Healthcare Dr
Ste 200
Edwardsville, IL 62025
Phone (618) 288-8500

550 Warrenville Rd
Ste 200
Lisle, IL 60532
Phone (312) 776-2422

2236 Vadalabene Dr
Ste 2
Maryville, IL 62062
Phone (618) 288-6136

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

Organizations & group practices 3

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 2

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": "1495584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1609304401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162 BOX 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628501",
            "telephone_number": "618-391-6405",
            "fax_number": "618-288-4088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6616 CENTER GROVE RD.",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "62025",
            "telephone_number": "618-659-1599",
            "fax_number": "618-659-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENMON",
        "first_name": "BETH",
        "middle_name": "ANN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-24",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209015530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14017183",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

Verify at the official NPI Registry.