Individual provider Active NPI

Barbara Jean Deyoung, FNP-BC

  • Family Nurse Practitioner
  • Kankakee, IL
National Provider Identifier
1891153888
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209013846 Issued in IL
Practice address
500 N Wall St Ste C400
Kankakee, IL 60901-2942
Phone
(815) 933-3814
Fax
(815) 933-3846
NPI assigned
Feb 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041354464 IL
Family Nurse Practitioner 363LF0000X 209013846 IL Primary

Addresses

Primary practice location

500 N Wall St Ste C400
Kankakee, IL 60901-2942

Mailing address

500 N Wall St Ste C400
Kankakee, IL 60901-2942
Phone (815) 933-3814

Other names 1

  • Barbara Jean Harris Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bdeyoung12754@Direct.riversidehealthcare.net Direct

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
I20160315002796 IL Practitioner - Nurse Practitioner 2668778705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

400 N Wall St
Suite 402
Kankakee, IL 60901-2963
Phone 81593272008808

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
041354464ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Feb 23, 2016 Accepting new patients
Riverside Health System CurrentSince Feb 23, 2016 Accepting new patients

Locations

300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666

500 N Wall St
Ste C400
Kankakee, IL 60901
Phone (815) 933-3814

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

400 N Wall St
Ste 402
Kankakee, IL 60901
Phone (815) 932-7200

375 N Wall St
Ste P410
Kankakee, IL 60901
Phone (815) 932-7474

1601 Butterfield Trl
Kankakee, IL 60901
Phone (815) 936-6500

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Interoperability endpoints

  • Direct secure messaging: bdeyoung12754@direct.riversidehealthcare.net

Organizations & group practices 2

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": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1891153888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N WALL ST STE C400",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012942",
            "telephone_number": "815-933-3814",
            "fax_number": "815-933-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N WALL ST STE C400",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012942",
            "telephone_number": "815-933-3814",
            "fax_number": "815-933-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYOUNG",
        "first_name": "BARBARA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041354464",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bdeyoung12754@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 N Wall St Ste C400",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609012942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BARBARA",
            "last_name": "HARRIS",
            "middle_name": "JEAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.