Active NPI
Jessica Milburn, NP
- Nurse Practitioner
- Carbondale, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 209013877
- Practice address
- 409 W Oak St
Carbondale, IL 62901-1464 - Phone
- (618) 529-4455
- Fax
- (618) 351-1287
- NPI assigned
- Mar 14, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209013877 | IL | Primary |
Addresses
Primary practice location
409 W Oak St
Carbondale, IL 62901-1464
Mailing address
PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200
Other practice location 1
3905 W Ernestine Dr
Marion, IL 62959-5800
Phone (618) 529-4455
Other practice location 2
2 S Hospital Dr Fl 2
Murphysboro, IL 62966-3333
Phone (618) 529-4455
Other practice location 3
217 S Park Ave Ste 2
Herrin, IL 62948-3611
Phone (618) 529-4455
Electronic endpoints 4
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jmilburn20504@sih.direct-ci.com | ||
| Direct Messaging Address | jmilburn20504@sih.direct-ci.com | ||
| Direct Messaging Address | jmilburn20504@sih.direct-ci.com | ||
| Direct Messaging Address | jmilburn20504@sih.direct-ci.com |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Illinois Medical Services, NFP | Current | Accepting new patients | |
| Southern Orthopedic Associates SC | Current | Accepting new patients | |
| Pediatric Group LLC | Past | Accepting new patients | |
| Pediatric Group LLC | Past | Accepting new patients |
Locations
2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300
409 W Oak St
Carbondale, IL 62901
Phone (618) 536-2565
117 E Clark St
Harrisburg, IL 62946
Phone (618) 252-8625
510 Lincoln Dr
Herrin, IL 62948
Phone (618) 997-3100
217 S Park Ave
Ste 2
Herrin, IL 62948
3905 W Ernestine Dr
Marion, IL 62959
Phone (573) 331-5761
3412 Office Park Dr
Marion, IL 62959
Phone (618) 993-0404
2 S Hospital Dr
Fl 2
Murphysboro, IL 62966
Interoperability endpoints
- jessica.milburn.1@11869.direct.athenahealth.com
- https://api.platform.athenahealth.com/11869/brand/1/csg/1/fhir/r4
- jmilburn20504@sih.direct-ci.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
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.
-
- Internal Medicine Physician
- Carbondale, IL
- NPI 1770656837
-
- Orthopaedic Surgery Physician
- Herrin, IL
- NPI 1396792412
-
- Rural Health Clinic/Center
- Carbondale, IL
- NPI 1023582038
-
- Rural Health Clinic/Center
- Marion, IL
- NPI 1114129970
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681776000000",
"number": "1669833026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3988",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629023988",
"telephone_number": "618-457-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 W OAK ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629011464",
"telephone_number": "618-529-4455",
"fax_number": "618-351-1287"
}
],
"practiceLocations": [
{
"address_1": "3905 W Ernestine Dr",
"address_purpose": "LOCATION",
"city": "Marion",
"state": "IL",
"postal_code": "629595800",
"country_code": "US",
"telephone_number": "618-529-4455",
"fax_number": "618-351-1287",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2 S Hospital Dr Fl 2",
"address_purpose": "LOCATION",
"city": "Murphysboro",
"state": "IL",
"postal_code": "629663333",
"country_code": "US",
"telephone_number": "618-529-4455",
"fax_number": "618-351-1287",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "217 S Park Ave Ste 2",
"address_purpose": "LOCATION",
"city": "Herrin",
"state": "IL",
"postal_code": "629483611",
"country_code": "US",
"telephone_number": "618-529-4455",
"fax_number": "618-351-1287",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MILBURN",
"first_name": "JESSICA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-14",
"last_updated": "2023-04-18",
"certification_date": "2023-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209013877",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmilburn20504@sih.direct-ci.com",
"affiliation": "N",
"address_1": "2 S Hospital Dr Fl 2",
"city": "Murphysboro",
"state": "IL",
"country_code": "US",
"postal_code": "629663333",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmilburn20504@sih.direct-ci.com",
"affiliation": "N",
"address_1": "3905 W Ernestine Dr",
"city": "Marion",
"state": "IL",
"country_code": "US",
"postal_code": "629595800",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmilburn20504@sih.direct-ci.com",
"affiliation": "N",
"address_1": "409 W Oak St",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629011464",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jmilburn20504@sih.direct-ci.com",
"affiliation": "N",
"address_1": "217 S Park Ave Ste 2",
"city": "Herrin",
"state": "IL",
"country_code": "US",
"postal_code": "629483611",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.