Nicole Edith Norris, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-111100 Issued in IL

Practice address

600 E 1St St
Spring Valley, IL 61362-1512

Phone

(815) 663-5981

Fax

(815) 663-5982

NPI assigned

Jun 16, 2005

Last updated

Apr 15, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Memorial Hospital of South Bend

  • General Acute Care Hospital
  • South Bend, IN
  • NPI 1295772093
  NPD (past)

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1689679599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E 1ST ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621512",
            "telephone_number": "815-663-5981",
            "fax_number": "815-663-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E 1ST ST",
            "city": "SPRING VALLEY",
            "state": "IL",
            "postal_code": "613621512",
            "telephone_number": "815-663-5981",
            "fax_number": "815-663-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "NICOLE",
        "middle_name": "EDITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-111100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036111100",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Maschmann, MD
• Mendota Community Hospital (OSF Healthcare - Medical Group - Spring Valley)
• Michael S Morrow, MD
• Robert W Morrow III, MD
• Amanda Neurohr, OTR, ATC
• Pack Machine Incorporated
• Ram S. Pankaj, MD
• Cameron Phalen
• Merle A Piacenti, MD
• Prairieland Private Duty

• Family Medicine Physician in Spring Valley, IL
• Providers in Spring Valley, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.