Individual provider Active NPI

Dana M Stephens, N.P.

  • Pediatric Nurse Practitioner
  • Morton, IL
National Provider Identifier
1730353186
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209004739 Issued in IL
Practice address
1909 N Morton Ave
Morton, IL 61550-1426
Phone
(309) 263-9124
Fax
(309) 266-8696
NPI assigned
Apr 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209004739 IL Primary

Addresses

Primary practice location

1909 N Morton Ave
Morton, IL 61550-1426

Mailing address

1909 N Morton Ave
Morton, IL 61550-1426
Phone (309) 263-9124

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
I20090331000593 IL Practitioner - Nurse Practitioner 0244397586 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.28 of 100Reported as group
Quality
73.53
Promoting interoperability
100
Improvement activities
40
Cost
70.73

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Board of Trustees of the University of Illinois CurrentSince Feb 6, 2019 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Dec 1, 2015 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Feb 6, 2019 Accepting new patients
Methodist Medical Center of Illinois Pediatrics CurrentSince Dec 1, 2015 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

7694 Solutions Ctr
Chicago, IL 60677

2535 E Washington St
East Peoria, IL 61611
Phone (309) 694-6464

1909 N Morton Ave
Morton, IL 61550
Phone (309) 263-9124

507 E Armstrong Ave
Peoria, IL 61603
Phone (309) 681-6960

815 Main St
Ste A1
Peoria, IL 61602

530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553

1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

3915 Barring Trce
Peoria, IL 61615
Phone (309) 689-3030

1120 E War Memorial Dr
Peoria Hts, IL 61616
Phone (309) 685-1774

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1730353186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 N MORTON AVE",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501426",
            "telephone_number": "309-263-9124",
            "fax_number": "309-266-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 N MORTON AVE",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501426",
            "telephone_number": "309-263-9124",
            "fax_number": "309-266-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "DANA",
        "middle_name": "M",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209004739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

Verify at the official NPI Registry.