Individual provider Active NPI

Jessica Serena Marie Belobraydic, MSN, APRN, FNP-C

  • Nurse Practitioner
  • Herrin, IL
National Provider Identifier
1699120055
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209013998 Issued in IL
Practice address
220 S Park Ave FL 2
Herrin, IL 62948-3602
Phone
(618) 988-6240
NPI assigned
May 4, 2016
Last updated
Aug 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209013998 IL Primary
Family Nurse Practitioner 363LF0000X 209013998 IL

Addresses

Primary practice location

220 S Park Ave FL 2
Herrin, IL 62948-3602

Mailing address

220 S Park Ave FL 2
Herrin, IL 62948-3602
Phone (618) 988-6240

Other practice location 1

405 W Jackson St
Carbondale, IL 62902-9000
Phone (618) 549-0721

Other practice location 2

305 W Jackson St Ste 206
Carbondale, IL 62901-1474
Phone (618) 457-3006

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jbelobraydic14057@sih.direct-ci.com
Direct Messaging Address jbelobraydic14057@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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802003762 IL Practitioner - Nurse Practitioner 1658732938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

220 S Park Ave
FL 2
Herrin, IL 62948-3602
Phone (618) 988-6240

3333 W Deyoung St
Marion, IL 62959-5884
Phone (618) 998-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82 of 100Reported as group
Quality
55.9
Promoting interoperability
100
Improvement activities
40
Cost
72.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner CurrentSince Feb 2, 2026 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince Feb 2, 2026 Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince Jun 21, 2023 Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

305 W Jackson St
Ste 206
Carbondale, IL 62901
Phone (618) 457-3006

305 W Jackson St
Ste 301
Carbondale, IL 62901
Phone (618) 529-0520

405 W Jackson St
Carbondale, IL 62901

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

220 S Park Ave
Fl 2
Herrin, IL 62948
Phone (618) 988-6240

3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020

509 Hamacher St
Waterloo, IL 62298
Phone (618) 939-3939

Interoperability endpoints

  • Direct secure messaging: jbelobraydic14057@sih.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1462320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754265600000",
    "number": "1699120055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 S PARK AVE FL 2",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483602",
            "telephone_number": "618-988-6240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S PARK AVE FL 2",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483602",
            "telephone_number": "618-988-6240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 W Jackson St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629029000",
            "country_code": "US",
            "telephone_number": "618-549-0721",
            "fax_number": "618-529-0449",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 W Jackson St Ste 206",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011474",
            "country_code": "US",
            "telephone_number": "618-457-3006",
            "fax_number": "618-457-3007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELOBRAYDIC",
        "first_name": "JESSICA",
        "middle_name": "SERENA MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-04",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209013998",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013998",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbelobraydic14057@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "305 W Jackson St Ste 301",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011474",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbelobraydic14057@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "220 S Park Ave Fl 2",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

Verify at the official NPI Registry.