Individual provider Active NPI

Maurissa Heaton, APRN

  • Nurse Practitioner
  • Jacksonville, IL
National Provider Identifier
1649968660
Registry record updated Jun 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209027080 Issued in IL
Practice address
1745 W Walnut St
Jacksonville, IL 62650-6126
Phone
(217) 243-6454
NPI assigned
Apr 27, 2023
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
Nurse Practitioner 363L00000X 209027080 IL Primary

Addresses

Primary practice location

1745 W Walnut St
Jacksonville, IL 62650-6126

Mailing address

1745 W Walnut St
Jacksonville, IL 62650-6126
Phone (217) 243-6454

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mheaton394820@ewd.direct.hshs.org Direct

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
I20230726002075 IL Practitioner - Nurse Practitioner 8820459639 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HSHS Medical Group IncGroup PAC ID 5092857821, 212 clinicians

Practice addresses (Care Compare)

1745 W Walnut St
Jacksonville, IL 62650-6126
Phone (217) 243-6454

Hospital & facility affiliations

  • St Johns Hospital Hospital, Springfield, IL, CCN 140053
  • Jacksonville Memorial Hospital Hospital, Jacksonville, IL, CCN 141352

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HSHS Medical Group Inc CurrentSince Jun 26, 2023 Accepting new patients
SJL Health Systems Inc CurrentSince Jun 26, 2023 Accepting new patients
HSHS Medical Group Inc Current Accepting new patients
HSHS Medical Group Inc Past Accepting new patients

Locations

125 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3333

125 E Plummer Blvd
Ste A
Chatham, IL 62629
Phone (217) 483-3333

1900 E Lake Shore Dr
Ste 330
Decatur, IL 62521
Phone (217) 423-2889

1745 W Walnut St
Jacksonville, IL 62650
Phone (217) 243-6454

1512 N Green Mount Rd
O Fallon, IL 62269
Phone (618) 624-0100

3051 Hollis Dr
Fl 2
Springfield, IL 62704
Phone (217) 321-9321

Interoperability endpoints

  • Direct secure messaging: mheaton394820@ewd.direct.hshs.org

Organizations & group practices 4

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 2

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": "1682553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686268800000",
    "number": "1649968660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626506126",
            "telephone_number": "217-243-6454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W WALNUT ST",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626506126",
            "telephone_number": "217-243-6454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATON",
        "first_name": "MAURISSA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-27",
        "last_updated": "2023-06-09",
        "certification_date": "2023-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209027080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mheaton394820@ewd.direct.hshs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "1745 W Walnut St",
            "city": "Jacksonville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "626506126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

Verify at the official NPI Registry.