Individual provider Active NPI

Jennifer Annette Hortenstine-Grohler, L. C. P. C.

  • Professional Counselor
  • Decatur, IL
National Provider Identifier
1780807222
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180.001685 Issued in IL
Practice address
1770 E Lake Shore Dr
Suite #208
Decatur, IL 62521-3832
Phone
(217) 428-1900
Fax
(217) 428-0358
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 180.001685 IL Primary

Addresses

Primary practice location

1770 E Lake Shore Dr
Suite #208
Decatur, IL 62521-3832

Mailing address

RR 1 Box 18C
Sullivan, IL 61951-8712
Phone (217) 728-8848

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109003211 IL Practitioner - Mental Health Counselor 8527419019 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2512 Hurst Dr
Suite 130
Mattoon, IL 61938-9200
Phone (217) 258-5900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
180.001685ILMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 1, 2024 Accepting new patients
Hoopeston Community Memorial Hospital Current Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Jan 1, 2024 Accepting new patients
Choudary V. Kavuri MD, SC PastSince Nov 5, 1998 Accepting new patients

Locations

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Organizations & group practices 5

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780807222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 18C",
            "city": "SULLIVAN",
            "state": "IL",
            "postal_code": "619518712",
            "telephone_number": "217-728-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1770 E LAKE SHORE DR",
            "address_2": "SUITE #208",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625213832",
            "telephone_number": "217-428-1900",
            "fax_number": "217-428-0358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORTENSTINE-GROHLER",
        "first_name": "JENNIFER",
        "middle_name": "ANNETTE",
        "credential": "L. C. P. C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.001685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

Verify at the official NPI Registry.