Individual provider Active NPI

Stephanie Dawn Boyd, FNP-C

  • Family Medicine Physician
  • Elgin, IL
National Provider Identifier
1780459123
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
209028738 Issued in IL
Practice address
1530 N Randall Rd Ste 210
Elgin, IL 60123-7879
Phone
(224) 760-7322
NPI assigned
Nov 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 209028738 IL Primary

Addresses

Primary practice location

1530 N Randall Rd Ste 210
Elgin, IL 60123-7879

Mailing address

2509 E 950TH Rd
Casey, IL 62420-3812
Phone (217) 218-4679

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20231129001983 IL Practitioner - Nurse Practitioner 2365890597 Reassigns benefits to 1 organization
I20240524001172 IN Practitioner - Nurse Practitioner 2365890597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chestnut Health of Illinois LLCGroup PAC ID 2264747344, 38 clinicians

Practice addresses (Care Compare)

1530 N Randall Rd
Suite 210
Elgin, IL 60123-7879
Phone (224) 760-7322

Merit-based Incentive Payment System (MIPS)

Final score
13.26 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
44.21

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chestnut Health of Indiana PC CurrentSince Apr 17, 2024 Accepting new patients
Chestnut Health of Illinois LLC CurrentSince Nov 15, 2023 Accepting new patients

Locations

1530 N Randall Rd
Ste 210
Elgin, IL 60123
Phone (224) 760-7322

3518 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0358

Organizations & group practices 2

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": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1780459123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 E 950TH RD",
            "city": "CASEY",
            "state": "IL",
            "postal_code": "624203812",
            "telephone_number": "217-218-4679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N RANDALL RD STE 210",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237879",
            "telephone_number": "224-760-7322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "STEPHANIE",
        "middle_name": "DAWN",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "209028738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.