Individual provider Active NPI

Summer Alyssa Hinthorne, APN, WHNP

  • Women's Health Nurse Practitioner
  • Normal, IL
National Provider Identifier
1831416189
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
209.007775 Issued in IL
Practice address
2200 Jacobssen Dr Ste B
Normal, IL 61761-5516
Phone
(309) 451-1123
Fax
(309) 451-1212
NPI assigned
Apr 27, 2010
Last updated
Dec 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 209.007775 IL Primary

Addresses

Primary practice location

2200 Jacobssen Dr Ste B
Normal, IL 61761-5516

Mailing address

2200 Jacobssen Dr Ste B
Normal, IL 61761-5516
Phone (309) 451-1123

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
I20130128000484 IL Practitioner - Nurse Practitioner 0244484244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Medical Group, LLCGroup PAC ID 5991989477, 10 clinicians

Practice addresses (Care Compare)

1401 Eastland Dr
Suite B
Bloomington, IL 61701-3553
Phone (309) 663-9424

2200 Jacobssen Dr
Normal, IL 61761-5516
Phone (309) 451-1212

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.007775ILMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastrointestinal Institute, LLC. Current Accepting new patients
Premier Medical Group, LLC CurrentSince Oct 21, 2013 Accepting new patients
Premier Medical Group, LLC CurrentSince Oct 21, 2013 Accepting new patients
Miller Urogynecology, SC PastSince Oct 1, 2007 Accepting new patients

Locations

107 N Regency Dr
Ste 2
Bloomington, IL 61701
Phone (309) 665-0900

1401 Eastland Dr
Ste B
Bloomington, IL 61701
Phone (309) 662-9022

2200 Jacobssen Dr
Normal, IL 61761
Phone (309) 451-1121

2200 Jacobssen Dr
Ste B
Normal, IL 61761
Phone (309) 451-1123

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1321/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1831416189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JACOBSSEN DR STE B",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615516",
            "telephone_number": "309-451-1123",
            "fax_number": "309-451-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 JACOBSSEN DR STE B",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615516",
            "telephone_number": "309-451-1123",
            "fax_number": "309-451-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HINTHORNE",
        "first_name": "SUMMER",
        "middle_name": "ALYSSA",
        "credential": "APN, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-27",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209.007775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Normal, IL

Sources for this page

Verify at the official NPI Registry.