Jennifer Thery

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209011491 Issued in IL

Practice address

6805 State Route 162 Ste 201
Maryville, IL 62062-8530

Phone

(618) 288-5019

Fax

(618) 288-5059

NPI assigned

Apr 24, 2014

Last updated

Jun 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jersey Community HospitalGroup PAC ID 4587650445, 62 clinicians

Southern Illinois Associates LLCGroup PAC ID 2961489992, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jersey Community Hospital Hospital, Jerseyville, IL, CCN 140059

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17590/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir-myrecord.cerner.com/r4/f4be81d1-a15e-4e19-9601-5214010ddaac/
• FHIR API: https://fhir-usa.unify.chbase.com/org/jersey-f23a6357
• FHIR API: https://fhir4.healow.com/fhir/r4/AFHDDD

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.

• Southern Illinois Associates LLC

  • Psychiatry Physician
  • Maryville, IL
  • NPI 1962427856
  Medicare reassignment Care Compare group NPD
• Jersey Community Hospital

  • Personal Emergency Response Attendant
  • Jerseyville, IL
  • NPI 1780609925
  Medicare reassignment Care Compare group
• Behavioral Health Alternatives, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wood River, IL
  • NPI 1619062676
  NPD
• Jersey Community Hospital

  • General Acute Care Hospital
  • Jerseyville, IL
  • NPI 1184630519
  NPD
• Jersey Community Hospital

  • Rural Health Clinic/Center
  • Jerseyville, IL
  • NPI 1700423696
  NPD
• Psychiatric Urgent Care LLC

  • Urgent Care Clinic/Center
  • Maryville, IL
  • NPI 1134843451
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jersey Community Hospital

  • General Acute Care Hospital
  • Jerseyville, IL
  • NPI 1184630519
  Care Compare affiliation

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1730509159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6805 STATE ROUTE 162 STE 201",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628530",
            "telephone_number": "618-288-5019",
            "fax_number": "618-288-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6805 STATE ROUTE 162 STE 201",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628530",
            "telephone_number": "618-288-5019",
            "fax_number": "618-288-5059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16 Junction Dr W",
            "address_2": "Ste 2",
            "address_purpose": "LOCATION",
            "city": "Glen Carbon",
            "state": "IL",
            "postal_code": "620342996",
            "country_code": "US",
            "telephone_number": "618-288-5019",
            "fax_number": "618-288-5059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THERY",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-24",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209011491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Take It Easy Therapy PLLC
• Beth E Taylor, RD
• Patricia Teschke, M.D.
• Ursula Louise Thatch, M.D.
• The Center for Advanced Orthopedics, LLC
• Dee A. Thiems, PT
• Antonio Terell Thomas, PMNHP
• Caitlyn Thompson
• Tina M.F. Gingrich, MD, PC (Maryville Women's Center)
• Michelle Marie Tink, DPT

• Psychiatric/Mental Health Nurse Practitioner in Maryville, IL
• Providers in Maryville, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.