Riley Renee Clubb, BSN, RN, DNP, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209029835 Issued in IL

Practice address

805 Saint Francis Way
Litchfield, IL 62056-1779

Phone

(217) 250-2380

NPI assigned

May 30, 2023

Last updated

Jul 17, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Riley Renee Spickerman Former name

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southern Illinois Associates LLCGroup PAC ID 2961489992, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Anderson Hospital Hospital, Maryville, IL, CCN 140289

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17590/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/AFHDDD

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.

• Southern Illinois Associates LLC

  • Psychiatry Physician
  • Maryville, IL
  • NPI 1962427856
  Medicare reassignment Care Compare group NPD
• Psychiatric Urgent Care LLC

  • Urgent Care Clinic/Center
  • Maryville, IL
  • NPI 1134843451
  NPD

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

• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation

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

{
    "created_epoch": "1685404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1881387660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 E MAPLE ST",
            "city": "GILLESPIE",
            "state": "IL",
            "postal_code": "620331473",
            "telephone_number": "217-839-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 SAINT FRANCIS WAY",
            "city": "LITCHFIELD",
            "state": "IL",
            "postal_code": "620561779",
            "telephone_number": "217-250-2380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 Oakland Ave",
            "address_purpose": "LOCATION",
            "city": "Carlinville",
            "state": "IL",
            "postal_code": "626261921",
            "country_code": "US",
            "telephone_number": "217-854-3223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 E Maple St",
            "address_purpose": "LOCATION",
            "city": "Gillespie",
            "state": "IL",
            "postal_code": "620331473",
            "country_code": "US",
            "telephone_number": "217-839-4100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLUBB",
        "first_name": "RILEY",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "BSN, RN, DNP, PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-30",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209029835",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.454256",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RILEY",
            "last_name": "SPICKERMAN",
            "middle_name": "RENEE",
            "prefix": "MS.",
            "credential": "BSN, RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cep America-Illinois Hospitalists, LLP
• Cepamerica Illinois LLP
• Shih Fang Cheng, DMD
• Alan E. Chiles, DMD
• City of Litchfield
• Keith Allen Cochran, MD
• Coffman Drug Store Inc (Coffman Drug Store)
• Janis E Collins, APN
• Karen Cress, LCPC
• Jimmy Dapog

• Psychiatric/Mental Health Nurse Practitioner in Litchfield, IL
• Providers in Litchfield, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.