Active NPI
Alyssa M Brown, CPNP-AC
- Pediatric Nurse Practitioner
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 209.025451
- Practice address
- 415 N 9TH St Ste 4W64
Springfield, IL 62702-5303 - Phone
- (217) 545-8000
- Fax
- (217) 545-6654
- NPI assigned
- Sep 13, 2022
- Last updated
- May 18, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 2022034477 | MO | |
| Pediatric Nurse Practitioner | 363LP0200X | 209.025451 | IL | Primary |
Addresses
Primary practice location
415 N 9TH St Ste 4W64
Springfield, IL 62702-5303
Mailing address
PO Box 19639
Springfield, IL 62794-9639
Phone (217) 545-8000
Other names 1
- Alyssa Wichmann
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | St. Louis Children's Hospital |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.025451 | IL | MD | Pediatric Nurse Practitioner |
| 2022034477 | MO | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients | |
| Siu Physicians & Surgeons, Inc | Current | Accepting new patients |
Locations
301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003
400 N 9th St
Springfield, IL 62702
Phone (217) 545-6498
400 N 9th St
Fl 2
Springfield, IL 62702
415 N 9th St
Ste 4W64
Springfield, IL 62702
Phone (217) 545-0003
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747526400000",
"number": "1891417283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19639",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627949639",
"telephone_number": "217-545-8000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 N 9TH ST STE 4W64",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627025303",
"telephone_number": "217-545-8000",
"fax_number": "217-545-6654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "ALYSSA",
"middle_name": "M",
"credential": "CPNP-AC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-13",
"last_updated": "2025-05-18",
"certification_date": "2025-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "MO",
"license": "2022034477",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IL",
"license": "209.025451",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
"affiliation": "Y",
"endpointDescription": "BJC",
"affiliationName": "St. Louis Children's Hospital",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1 Childrens Pl",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631101081",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "ALYSSA",
"last_name": "WICHMANN",
"credential": "CPNP-AC",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2025; 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.