Individual provider Active NPI

Yolanda A Suber, FNP-C

  • Family Nurse Practitioner
  • Alton, IL
National Provider Identifier
1841842341
Registry record updated Jul 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209017263 Issued in IL
Practice address
2615 Edwards St Ste 171
Alton, IL 62002-3915
Phone
(618) 462-4342
Fax
(618) 462-5334
NPI assigned
Jul 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209017263 IL Primary

Addresses

Primary practice location

2615 Edwards St Ste 171
Alton, IL 62002-3915

Mailing address

2615 Edwards St Ste 171
Alton, IL 62002-3915
Phone (618) 462-4342

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
I20191023003681 IL Practitioner - Nurse Practitioner 5698007680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2001 State St
East Saint Louis, IL 62205-1803
Phone (618) 271-9191

2615 Edwards St
Alton, IL 62002-3915
Phone (618) 462-4342

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209017263ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation Inc CurrentSince Aug 18, 2019 Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Aug 18, 2019 Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Jul 25, 2019 Accepting new patients

Locations

2615 Edwards St
Ste 171
Alton, IL 62002
Phone (618) 462-4342

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

Interoperability endpoints

  • Direct secure messaging: yolanda.suber.1@9559.direct.athenahealth.com

Organizations & group practices 3

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": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1841842341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 EDWARDS ST STE 171",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620023915",
            "telephone_number": "618-462-4342",
            "fax_number": "618-462-5334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 EDWARDS ST STE 171",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620023915",
            "telephone_number": "618-462-4342",
            "fax_number": "618-462-5334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBER",
        "first_name": "YOLANDA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209017263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.