NPIMap

Individual provider Active NPI

Nicole Montes Corkery, MD

  • Internal Medicine Physician
  • Springfield, IL
National Provider Identifier
1609306711
Registry record updated Apr 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036153098 Issued in IL
Practice address
3132 Old Jacksonville Rd Ste 200
Springfield, IL 62704-7401
Phone
(217) 862-0800
Fax
(217) 862-0871
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036153098 IL Primary

Addresses

Primary practice location

3132 Old Jacksonville Rd Ste 200
Springfield, IL 62704-7401

Mailing address

3132 Old Jacksonville Rd Ste 200
Springfield, IL 62704-7401
Phone (217) 862-0800

Other identifiers 1

IdentifierTypeStateIssuer
036153098OtherILMD LICENSE

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
I20201110000098 IL Practitioner - Internal Medicine 9032480025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Memorial Physician ServicesGroup PAC ID 9032005681, 161 clinicians

Practice addresses (Care Compare)

3132 Old Jacksonville Rd
Suite 200
Springfield, IL 62704-7401
Phone (217) 862-0800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.44 of 100Reported as group
Quality
71.79
Promoting interoperability
77
Improvement activities
40
Cost
75.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Physician Services CurrentSince Oct 19, 2020 Accepting new patients
Family Medical Center of Chatham, LLC Current Accepting new patients
Springfield Clinic LLP Current Accepting new patients
Memorial Physician Services Current Accepting new patients
Memorial Health Partners Current Accepting new patients
Memorial Physician Services Internal Medicine CurrentSince Oct 19, 2020 Accepting new patients

Locations

101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487

3132 Old Jacksonville Rd
Ste 200
Springfield, IL 62704
Phone (217) 862-0800

Interoperability endpoints

  • Direct secure messaging: nicolemontescorkery@sfc.allscriptsdirect.net
  • Direct secure messaging: nicolemontescorkery@memorial.allscriptsdirect.net

Organizations & group practices 7

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": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1609306711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD STE 200",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047401",
            "telephone_number": "217-862-0800",
            "fax_number": "217-862-0871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3132 OLD JACKSONVILLE RD STE 200",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047401",
            "telephone_number": "217-862-0800",
            "fax_number": "217-862-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTES CORKERY",
        "first_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036153098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "036153098",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.