Individual provider Active NPI

Jayden Foote, PA-C

  • Physician Assistant
  • Springfield, IL
National Provider Identifier
1851160873
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.010453 Issued in IL
Practice address
3220 Atlanta St
Springfield, IL 62707-8801
Phone
(217) 545-8000
NPI assigned
Jan 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.010453 IL Primary

Addresses

Primary practice location

3220 Atlanta St
Springfield, IL 62707-8801

Mailing address

201 E Madison St Ste 328
Springfield, IL 62702-5131
Phone (217) 545-8000

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
I20240605002164 IL Practitioner - Physician Assistant 4385186352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Board of Trustees of Southern Illinois UniversityGroup PAC ID 4486667888, 139 clinicians

Practice addresses (Care Compare)

3220 Atlanta St
Springfield, IL 62707-8801
Phone (217) 545-8000

520 N 4TH St
Springfield, IL 62702-5238
Phone (217) 545-8000

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.010453ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of Southern Illinois University CurrentSince Jun 1, 2024 Accepting new patients
Board of Trustees of Southern Illinois University CurrentSince Jun 1, 2024 Accepting new patients
Southern Illinois University Past Accepting new patients

Locations

520 N 4th St
Springfield, IL 62702
Phone (217) 757-8100

3220 Atlanta St
Springfield, IL 62707
Phone (217) 588-2600

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": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1851160873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E MADISON ST STE 328",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627025131",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 ATLANTA ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627078801",
            "telephone_number": "217-545-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOOTE",
        "first_name": "JAYDEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.010453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

Verify at the official NPI Registry.