NPIMap

Individual provider Active NPI

Nicollette M Haubrich, FNP-BC

  • Family Nurse Practitioner
  • Quincy, IL
National Provider Identifier
1619212107
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209009999 Issued in IL
Practice address
4800 Maine St
Quincy, IL 62305-5875
Phone
(217) 214-0444
Fax
(217) 214-9639
NPI assigned
Dec 10, 2012
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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 209009999 IL Primary

Addresses

Primary practice location

4800 Maine St
Quincy, IL 62305-5875

Mailing address

1005 Broadway St
Quincy, IL 62301-2834
Phone (217) 223-8400

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address nhaubrich23856@blessing.medalliesdirect.net Direct

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
I20130308000305 IL Practitioner - Nurse Practitioner 2466607882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blessing HospitalGroup PAC ID 3072422534, 414 clinicians

Practice addresses (Care Compare)

4800 Maine St
Quincy, IL 62305-5875
Phone (217) 224-6423

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-009999ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blessing Hospital CurrentSince Oct 14, 2021 Accepting new patients
West Central Pathology Specialists, S.C. Current Accepting new patients
Blessing Hospital CurrentSince Oct 14, 2021 Accepting new patients
Quincy Clinical Laboratory Services SC Current Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients
Blessing Hospital Past Accepting new patients
Blessing Corporate Services Inc Past Accepting new patients

Locations

640 W Washington St
Pittsfield, IL 62363
Phone (217) 285-2113

1005 Broadway St
Quincy, IL 62301

4800 Maine St
Quincy, IL 62305
Phone (217) 214-0444

927 Broadway St
Ste 101
Quincy, IL 62301
Phone (217) 214-5660

927 Broadway St
Ste 106
Quincy, IL 62301

Interoperability endpoints

  • FHIR API: https://fhir.blessinghospital.com/R4/open-Prod
  • Direct secure messaging: nicollettehaubrich@bcs.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1619212107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012834",
            "telephone_number": "217-223-8400",
            "fax_number": "217-277-3960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623055875",
            "telephone_number": "217-214-0444",
            "fax_number": "217-214-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAUBRICH",
        "first_name": "NICOLLETTE",
        "middle_name": "M",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-10",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209009999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nhaubrich23856@blessing.medalliesdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4800 Maine St",
            "city": "Quincy",
            "state": "IL",
            "country_code": "US",
            "postal_code": "623055875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

Verify at the official NPI Registry.