Individual provider Active NPI

Jessi R. Prentice, FNP-BC

  • Family Nurse Practitioner
  • Springfield, IL
National Provider Identifier
1710387154
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209011768 Issued in IL
Practice address
1025 S 6TH St
Springfield, IL 62703-2403
Phone
(217) 528-7541
NPI assigned
Sep 3, 2014
Last updated
Apr 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209011768 IL Primary

Addresses

Primary practice location

1025 S 6TH St
Springfield, IL 62703-2403

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Other practice location 1

1100 Centre West Dr
Springfield, IL 62704-2100
Phone (217) 528-7541

Other names 1

  • Jessi R. Brown Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jprentice@springfieldclinic.intellechartdirect.net 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
I20140918001911 IL Practitioner - Nurse Practitioner 6709005093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Springfield Clinic, LLPGroup PAC ID 0547166076, 678 clinicians

Practice addresses (Care Compare)

1100 Centre W Dr
Springfield, IL 62704-2100
Phone (217) 793-9960

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as apm
Quality
75.65
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Clinic, LLP CurrentSince Sep 3, 2014 Accepting new patients

Locations

1025 S 6th St
Springfield, IL 62703

1100 Centre West Dr
Springfield, IL 62704
Phone (217) 793-9960

4525 Wabash Ave
Springfield, IL 62711

775 Engineering Ave
Springfield, IL 62703
Phone (217) 522-4300

Interoperability endpoints

  • Direct secure messaging: jessi.prentice.1@28977.direct.athenahealth.com
  • Direct secure messaging: jprentice@springfieldclinic.intellechartdirect.net

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1710387154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Centre West Dr",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627042100",
            "country_code": "US",
            "telephone_number": "217-528-7541",
            "fax_number": "217-793-8806",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRENTICE",
        "first_name": "JESSI",
        "middle_name": "R.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jprentice@springfieldclinic.intellechartdirect.net",
            "affiliation": "N",
            "endpointDescription": "Nextech",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1025 S 6th St",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627032403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JESSI",
            "last_name": "BROWN",
            "middle_name": "R.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.