Individual provider Active NPI

Ella Caitlin Edwards, APN

  • Nurse Practitioner
  • Carbondale, IL
National Provider Identifier
1821348988
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209009794 Issued in IL
Practice address
409 W Oak St
Carbondale, IL 62901-1464
Phone
(618) 529-4455
Fax
(618) 351-1287
NPI assigned
Sep 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209009794 IL Primary

Addresses

Primary practice location

409 W Oak St
Carbondale, IL 62901-1464

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

217 S Park Ave Ste 2
Herrin, IL 62948-3611
Phone (618) 529-4455

Other practice location 2

3905 W Ernestine Dr
Marion, IL 62959-5800
Phone (618) 529-4455

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address eedwards15537@sih.direct-ci.com
Direct Messaging Address eedwards15537@sih.direct-ci.com
Direct Messaging Address eedwards15537@sih.direct-ci.com

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
I20130314000243 IL Practitioner - Nurse Practitioner 1850536178 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Deaconess Illinois Specialty Clinic, Inc.Group PAC ID 9830562016, 145 clinicians

Practice addresses (Care Compare)

3333 W Deyoung St
Marion, IL 62959-5884
Phone (618) 998-7000

Hospital & facility affiliations

  • Heartland Regional Medical Center Hospital, Marion, IL, CCN 140184

Merit-based Incentive Payment System (MIPS)

Final score
77.51 of 100Reported as group
Quality
49.04
Promoting interoperability
95
Improvement activities
40
Cost
69.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209009794ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Medical Services, NFP CurrentSince Sep 5, 2017 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Interventional Cardiology Current Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner CurrentSince Jun 6, 2023 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. CurrentSince Jun 6, 2023 Accepting new patients
Deaconess Illinois Clinic, Inc Past Accepting new patients

Locations

517 N Main St
Anna, IL 62906
Phone (618) 833-2295

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

409 W Oak St
Carbondale, IL 62901
Phone (618) 536-2565

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

217 S Park Ave
Ste 1
Herrin, IL 62948
Phone (618) 942-7402

217 S Park Ave
Ste 2
Herrin, IL 62948

3905 W Ernestine Dr
Marion, IL 62959
Phone (573) 331-5761

3333 W Deyoung St
Marion, IL 62959
Phone (618) 998-7020

Interoperability endpoints

  • Direct secure messaging: eedwards15537@sih.direct-ci.com
  • Direct secure messaging: eedwar02@yourcarecommunity.org

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1821348988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W OAK ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011464",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "217 S Park Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483611",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3905 W Ernestine Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "IL",
            "postal_code": "629595800",
            "country_code": "US",
            "telephone_number": "618-529-4455",
            "fax_number": "618-351-1287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ELLA",
        "middle_name": "CAITLIN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209009794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eedwards15537@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "409 W Oak St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011464",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eedwards15537@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "217 S Park Ave Ste 2",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eedwards15537@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "3905 W Ernestine Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

Verify at the official NPI Registry.