Individual provider Active NPI

Jenna Marie Whitehead, NP

  • Nurse Practitioner
  • Marion, IL
National Provider Identifier
1891452439
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209023902 Issued in IL
Practice address
3106 Outer Dr
Marion, IL 62959-5270
Phone
(618) 997-4332
Fax
(618) 351-4857
NPI assigned
Nov 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209023902 IL Primary

Addresses

Primary practice location

3106 Outer Dr
Marion, IL 62959-5270

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other practice location 1

405 Rushing Dr
Herrin, IL 62948-3730
Phone (618) 993-3300

Other practice location 2

502 W Saint Louis St Ste 400
West Frankfort, IL 62896-1968
Phone (618) 937-3400

Other practice location 3

117 E Clark St
Harrisburg, IL 62946-2702
Phone (618) 252-8625

Other practice location 4

2601 W Main St
Carbondale, IL 62901-1031
Phone (618) 549-5361

Other practice location 5

1007 US Highway 45 N
Eldorado, IL 62930-3767
Phone (618) 273-7723

Electronic endpoints 6

TypeEndpointUseAffiliation
Direct Messaging Address jwhitehead7473@sih.direct-ci.com
Direct Messaging Address jwhitehead7473@sih.direct-ci.com
Direct Messaging Address jwhitehead7473@sih.direct-ci.com
Direct Messaging Address jwhitehead7473@sih.direct-ci.com
Direct Messaging Address jwhitehead7473@sih.direct-ci.com
Direct Messaging Address jwhitehead7473@sih.direct-ci.com

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
I20211208002957 IL Practitioner - Nurse Practitioner 1254721152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harrisburg Medical Center IncGroup PAC ID 9638083884, 19 clinicians
Logan Primary Care Service Corp.Group PAC ID 8628967064, 33 clinicians

Practice addresses (Care Compare)

3106 Outer Dr
Marion, IL 62959-5270
Phone (618) 997-4332

405 Rushing Dr
Herrin, IL 62948-3730
Phone (618) 993-3300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.73 of 100Reported as group
Quality
90.64
Promoting interoperability
100
Improvement activities
40
Cost
68.46

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Harrisburg Medical Center Inc Current Accepting new patients
Southern Illinois Medical Services, NFP CurrentSince May 4, 2024 Accepting new patients
Harrisburg Medical Center Inc Past Accepting new patients
Harrisburg Medical Center Inc Past Accepting new patients
Harrisburg Medical Center Inc Past Accepting new patients

Locations

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

1007 US Highway 45 N
Eldorado, IL 62930
Phone (618) 273-7723

117 E Clark St
Harrisburg, IL 62946
Phone (618) 252-8625

405 Rushing Dr
Herrin, IL 62948
Phone (618) 993-3300

3106 Outer Dr
Marion, IL 62959
Phone (618) 997-4332

3106 Outer Dr
#200
Marion, IL 62959

502 W Saint Louis St
Ste 400
West Frankfort, IL 62896
Phone (618) 937-3400

Interoperability endpoints

  • Direct secure messaging: jwhitehead7473@sih.direct-ci.com
  • FHIR API: https://fhir-usa.unify.chbase.com/org/harrisb-43985171

Organizations & group practices 5

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 7

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": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1891452439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 OUTER DR",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595270",
            "telephone_number": "618-997-4332",
            "fax_number": "618-351-4857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Rushing Dr",
            "address_purpose": "LOCATION",
            "city": "Herrin",
            "state": "IL",
            "postal_code": "629483730",
            "country_code": "US",
            "telephone_number": "618-993-3300",
            "fax_number": "618-993-0262",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "502 W Saint Louis St Ste 400",
            "address_purpose": "LOCATION",
            "city": "West Frankfort",
            "state": "IL",
            "postal_code": "628961968",
            "country_code": "US",
            "telephone_number": "618-937-3400",
            "fax_number": "618-997-9324",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "117 E Clark St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "IL",
            "postal_code": "629462702",
            "country_code": "US",
            "telephone_number": "618-252-8625",
            "fax_number": "618-351-4859",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2601 W Main St",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629011031",
            "country_code": "US",
            "telephone_number": "618-549-5361",
            "fax_number": "618-351-4878",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1007 US Highway 45 N",
            "address_purpose": "LOCATION",
            "city": "Eldorado",
            "state": "IL",
            "postal_code": "629303767",
            "country_code": "US",
            "telephone_number": "618-273-7723",
            "fax_number": "618-351-4834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209023902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwhitehead7473@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "2601 W Main St",
            "city": "Carbondale",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629011031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwhitehead7473@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "1007 US Highway 45 N",
            "city": "Eldorado",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629303767",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwhitehead7473@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "117 E Clark St",
            "city": "Harrisburg",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629462702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwhitehead7473@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "405 Rushing Dr",
            "city": "Herrin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629483730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwhitehead7473@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "502 W Saint Louis St Ste 400",
            "city": "West Frankfort",
            "state": "IL",
            "country_code": "US",
            "postal_code": "628961968",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwhitehead7473@sih.direct-ci.com",
            "affiliation": "N",
            "address_1": "3106 Outer Dr",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629595270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

Verify at the official NPI Registry.