Empowerme NP, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

EMPOWERME NP, LLC

Practice address

1815 N Towanda Barnes Rd
Bloomington, IL 61705-2802

Phone

(844) 502-7996

NPI assigned

Nov 29, 2021

Last updated

Nov 29, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

John David Church

Title

Vice President Finance

Phone

(618) 972-5228

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638144000000",
    "number": "1639836406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1335 STRASSNER DR",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631441872",
            "telephone_number": "844-502-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 N TOWANDA BARNES RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617052802",
            "telephone_number": "844-502-7996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMPOWERME NP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "JOHN DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "618-972-5228"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Edward Ericksen

• Nurse Practitioner in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.