Jennifer Ellison, FNP
Individual provider Active NPI Nurse Practitioner · Springfield, IL
NPI 1669927984 · NPPES record last updated Aug 16, 2016
Key facts
- NPI
- 1669927984
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 209014641 (IL)
- Practice address
- 3132 Old Jacksonville Rd
Springfield, IL 62704-7400 - Phone
- (217) 862-0800
- NPI assigned
- Aug 16, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 79.44 of 100
- Quality
- 71.79
- Promoting interoperability
- 77
- Improvement activities
- 40
- Cost
- 75.71
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170104001812 | IL | Practitioner - Nurse Practitioner | 7416238548 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Physician Services | Nurse Practitioner | Current |
Accepting new patients |
| Springfield Clinic LLP | Current | Accepting new patients | |
| Memorial Physician Services | Current |
Accepting new patients | |
| Memorial Health Partners | Current | Accepting new patients | |
| Memorial Physician Services | Current | Accepting new patients | |
| Family Medical Center of Chatham, LLC | Nurse Practitioner | Current | Accepting new patients |
Locations
101 E Plummer Blvd
Chatham, IL 62629
Phone (217) 483-3487
3132 Old Jacksonville Rd
Springfield, IL 62704
Phone (217) 862-0062
3132 Old Jacksonville Rd
Ste 200
Springfield, IL 62704
Phone (217) 862-0800
Interoperability endpoints
- jenniferellison@memorial.allscriptsdirect.net
- jenniferellison@sfc.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 209014641 | IL | Yes |
Addresses
Primary practice location
3132 Old Jacksonville Rd
Springfield, IL 62704-7400
Mailing address
3132 Old Jacksonville Rd
Springfield, IL 62704-7400
Phone (217) 862-0800
Other names
- Jennifer O'Connell
Other providers in Springfield, IL
- Kylee Marie Elleman
- Jeremy Elliott
- Sandra K. Elliott
- Tiffany Elliott
- Melony D Ellis
- Joshua Ellison
- Taryn Ellison
- Amira Elmagbari
- Yansoun Younes Elmasry
- Todd David Elmore
All providers in Springfield, IL · Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.