Organization Active NPI

Advanced Practice Nursing Services Inc

  • Adult Health Nurse Practitioner
  • Freeburg, IL
National Provider Identifier
1861867863
Registry record updated Aug 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
Legal business name
ADVANCED PRACTICE NURSING SERVICES INC
Practice address
746 Urbanna Dr
Freeburg, IL 62243-1904
Phone
(618) 792-3586
NPI assigned
Dec 2, 2015
Last updated
Aug 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2023

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

Authorized official

Name
Kelly Whitaker, ANPNPI 1386932028
Title
President
Phone
(618) 792-3586

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X Primary

Addresses

Primary practice location

746 Urbanna Dr
Freeburg, IL 62243-1904

Mailing address

PO Box 303
Mascoutah, IL 62258-0303
Phone (618) 792-3586

Other practice location 1

1207 Larkspur Dr
Mascoutah, IL 62258-2739
Phone (618) 792-3586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170222002252 IL Part B Supplier - Clinic/Group Practice 4183908999 Receives reassigned benefits from 3 practitioners
Practice locations: Jerseyville, IL; Waterloo, IL; Swansea, IL; Sparta, IL; Shiloh, IL; O Fallon, IL; Millstadt, IL; Mascoutah, IL…

National Provider Directory

National Provider Directory

Locations

4350 Frank Scott Pkwy W
Belleville, IL 62223
Phone (618) 706-9764

401 S Moreland Rd
Bethalto, IL 62010
Phone (618) 377-3239

5 Club Centre Ct
#A
Edwardsville, IL 62025
Phone (618) 655-0333

1210 E Fairgrounds Ave
Jerseyville, IL 62052
Phone (618) 639-9700

124 W Main St
Mascoutah, IL 62258
Phone (618) 402-5572

735 Columbia Ave
Waterloo, IL 62298
Phone (618) 313-7611

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691280000000",
    "number": "1861867863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 303",
            "city": "MASCOUTAH",
            "state": "IL",
            "postal_code": "622580303",
            "telephone_number": "618-792-3586",
            "fax_number": "636-333-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "746 URBANNA DR",
            "city": "FREEBURG",
            "state": "IL",
            "postal_code": "622431904",
            "telephone_number": "618-792-3586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 Larkspur Dr",
            "address_purpose": "LOCATION",
            "city": "Mascoutah",
            "state": "IL",
            "postal_code": "622582739",
            "country_code": "US",
            "telephone_number": "618-792-3586",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED PRACTICE NURSING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2023-08-06",
        "certification_date": "2023-08-06",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-792-3586",
        "authorized_official_credential": "ANP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.