Active NPI
Alyssa Sabree Dudley, MSN, RN
- Registered Nurse
- Mount Vernon, IL
National Provider Identifier
1639880628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 041489008
- Practice address
- 4000 S Water Tower PL
Mount Vernon, IL 62864-2349 - Phone
- (618) 246-2910
- Fax
- (618) 242-8240
- NPI assigned
- Dec 9, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 041489008 | IL | Primary |
Addresses
Primary practice location
4000 S Water Tower PL
Mount Vernon, IL 62864-2349
Mailing address
2401 W Main St
Marion, IL 62959-1188
Phone (618) 997-5311
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | alyssa.dudley@va.gov | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041489008 | IL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1670544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670544000000",
"number": "1639880628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 W MAIN ST",
"city": "MARION",
"state": "IL",
"postal_code": "629591188",
"telephone_number": "618-997-5311",
"fax_number": "618-242-8240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 S WATER TOWER PL",
"city": "MOUNT VERNON",
"state": "IL",
"postal_code": "628642349",
"telephone_number": "618-246-2910",
"fax_number": "618-242-8240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "ALYSSA",
"middle_name": "SABREE",
"credential": "MSN, RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-12-09",
"last_updated": "2022-12-09",
"certification_date": "2022-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041489008",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "alyssa.dudley@va.gov",
"affiliation": "N",
"endpointDescription": "VA Email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4000 S Water Tower Pl",
"city": "Mount Vernon",
"state": "IL",
"country_code": "US",
"postal_code": "628642349",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Mount Vernon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.