Individual provider Active NPI

Marlee N Hager

  • Family Nurse Practitioner
  • Jacksonville, IL
National Provider Identifier
1629646567
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.023504 Issued in IL
Practice address
15 Founders LN Ste 100
Jacksonville, IL 62650-3924
Phone
(217) 243-0300
Fax
(217) 862-0202
NPI assigned
Jun 16, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2023

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 209.023504 IL Primary

Addresses

Primary practice location

15 Founders LN Ste 100
Jacksonville, IL 62650-3924

Mailing address

15 Founders LN Ste 100
Jacksonville, IL 62650-3924
Phone (217) 243-0300

Other identifiers 1

IdentifierTypeStateIssuer
041.444252OtherILRN

Other names 1

  • Marlee N Landon Former name

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
I20210805003421 IL Practitioner - Nurse Practitioner 8325442874 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
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)

15 Founders St
Suite 100
Jacksonville, IL 62650-3918
Phone (217) 243-0300

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.023504ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic LLP Current Accepting new patients
Memorial Physician Services Current Accepting new patients
Memorial Physician Services CurrentSince Jun 1, 2023 Accepting new patients
Memorial Physician Services CurrentSince Jun 1, 2023 Accepting new patients
Family Medical Center of Chatham, LLC Current Accepting new patients
Memorial Expresscare, LLC Past Accepting new patients

Locations

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

15 Founders Ln
Ste 100
Jacksonville, IL 62650
Phone (217) 243-0300

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

Interoperability endpoints

  • Direct secure messaging: marleehager@sfc.allscriptsdirect.net

Organizations & group practices 6

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 1

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": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1629646567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 FOUNDERS LN STE 100",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503924",
            "telephone_number": "217-243-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FOUNDERS LN STE 100",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626503924",
            "telephone_number": "217-243-0300",
            "fax_number": "217-862-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGER",
        "first_name": "MARLEE",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.023504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "041.444252",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLEE",
            "last_name": "LANDON",
            "middle_name": "N",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jacksonville, IL

Sources for this page

Verify at the official NPI Registry.