Individual provider Active NPI

Brandy M Byrd, FNP

  • Nurse Practitioner
  • Alton, IL
National Provider Identifier
1902217540
Registry record updated Sep 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209011350 Issued in IL
Practice address
4 Memorial Dr Ste 230
Alton, IL 62002-6704
Phone
(618) 463-7874
NPI assigned
May 16, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209011350 IL Primary
Family Nurse Practitioner 363LF0000X 209011350 IL
Nurse Practitioner 363L00000X 13397-30 WI
Nurse Practitioner 363L00000X 2015018041 MO

Addresses

Primary practice location

4 Memorial Dr Ste 230
Alton, IL 62002-6704

Mailing address

163 E Bethalto Dr
Bethalto, IL 62010-1801
Phone (618) 433-6640

Other practice location 1

3 Professional Dr Ste B
Alton, IL 62002-5067
Phone (618) 465-7177

Other practice location 2

500 Howdershell Rd
Florissant, MO 63031-6450
Phone (314) 687-2727

Other practice location 3

1821 S Stoughton Rd
Madison, WI 53716-2257
Phone (314) 989-6807

Other practice location 4

163 E Bethalto Dr
Bethalto, IL 62010-1801
Phone (618) 433-6640

Other identifiers 2

IdentifierTypeStateIssuer
1902217540MedicaidWI
209011350MedicaidIL

Electronic endpoints 5

TypeEndpointUseAffiliation
Direct Messaging Address bbyrd3315@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address bbyrd3315@direct-ehr-ssmhc.com Direct
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO, WI, OK4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20140715000496 IL Practitioner - Nurse Practitioner 6305061904 Reassigns benefits to 4 organizations
I20191213001318 MO Practitioner - Nurse Practitioner 6305061904 Reassigns benefits to 1 organization
I20221227000858 WI Practitioner - Nurse Practitioner 6305061904 Reassigns benefits to 1 organization
I20230327001526 OK Practitioner - Nurse Practitioner 6305061904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Heights Medical Group SCGroup PAC ID 6800784083, 448 clinicians

Practice addresses (Care Compare)

163 E Bethalto Dr
Bethalto, IL 62010-1801
Phone (618) 433-6490

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13397-30WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dean Health Systems, Inc. CurrentSince Dec 15, 2022 Accepting new patients
SSM Health Care St. Louis CurrentSince Nov 1, 2020 Accepting new patients
Dean Health Systems, Inc CurrentSince Dec 15, 2022 Accepting new patients
SSM Health Care St Louis CurrentSince Nov 1, 2020 Accepting new patients
Fairview Heights Medical Group SC CurrentSince Nov 1, 2023 Accepting new patients
Interventional Pain Consultants LLC CurrentSince Aug 1, 2018 Accepting new patients
Saints Medical Group, LLC CurrentSince Dec 14, 2022 Accepting new patients
Saints Medical Group, LLC CurrentSince Dec 14, 2022 Accepting new patients
Physician Services Corporation of Southern Illinois Inc. CurrentSince Sep 1, 2022 Accepting new patients
Interventional Pain Consultants LLC Nurse Practitioner CurrentSince Aug 1, 2018 Accepting new patients
Regenerative Health and Chiropractic, LTD CurrentSince May 2, 2022 Accepting new patients
Fairview Heights Medical Group SC Current Accepting new patients

Locations

1 Memorial Dr
Alton, IL 62002
Phone (618) 463-7240

3 Professional Dr
Ste B
Alton, IL 62002
Phone (618) 219-0855

4 Memorial Dr
Ste 230
Alton, IL 62002
Phone (618) 463-7874

163 E Bethalto Dr
Bethalto, IL 62010
Phone (618) 433-6490

1003 E McCord St
Centralia, IL 62801
Phone (618) 436-5231

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

2013 Johnson Rd
Ste D
Granite City, IL 62040
Phone (618) 931-2050

2 Good Samaritan Way
Ste 320
Mount Vernon, IL 62864
Phone (618) 899-1944

602 S 42nd St
#A
Mount Vernon, IL 62864
Phone (618) 899-3777

705 S Grand St
Nashville, IL 62263
Phone (618) 327-2200

4972 Benchmark Centre Dr
Swansea, IL 62226
Phone (618) 622-0303

3221 McKelvey Rd
Ste 301
Bridgeton, MO 63044

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1120 Shackelford Rd
Florissant, MO 63031
Phone (314) 830-5805

2022 Dorsett Vlg
Maryland Heights, MO 63043
Phone (314) 520-0520

3555 Sunset Office Dr
Ste C100
Saint Louis, MO 63127
Phone (314) 238-9100

660 Mason Ridge Center Dr
Saint Louis, MO 63141
Phone (314) 273-6433

1035 Bellevue Ave
Ste 500
Saint Louis, MO 63117
Phone (314) 647-1115

30 Ronnies Plz
Sappington, MO 63126
Phone (314) 748-5800

777 NW 63rd St
Ste 452
Oklahoma City, OK 73116

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

1821 S Stoughton Rd
Madison, WI 53716
Phone (608) 260-6000

1808 W Beltline Hwy
Madison, WI 53713
Phone (608) 250-1497

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: bbyrd3315@direct-ehr-ssmhc.com

Organizations & group practices 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758844800000",
    "number": "1902217540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 E BETHALTO DR",
            "city": "BETHALTO",
            "state": "IL",
            "postal_code": "620101801",
            "telephone_number": "618-433-6640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MEMORIAL DR STE 230",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026704",
            "telephone_number": "618-463-7874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Professional Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Alton",
            "state": "IL",
            "postal_code": "620025067",
            "country_code": "US",
            "telephone_number": "618-465-7177",
            "fax_number": "618-465-7176",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Howdershell Rd",
            "address_purpose": "LOCATION",
            "city": "Florissant",
            "state": "MO",
            "postal_code": "630316450",
            "country_code": "US",
            "telephone_number": "314-687-2727",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1821 S Stoughton Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537162257",
            "country_code": "US",
            "telephone_number": "314-989-6807",
            "fax_number": "314-989-2940",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "163 E Bethalto Dr",
            "address_purpose": "LOCATION",
            "city": "Bethalto",
            "state": "IL",
            "postal_code": "620101801",
            "country_code": "US",
            "telephone_number": "618-433-6640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYRD",
        "first_name": "BRANDY",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2025-09-26",
        "certification_date": "2025-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209011350",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209011350",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "13397-30",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2015018041",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902217540",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209011350",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbyrd3315@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bbyrd3315@direct-ehr-ssmhc.com",
            "address_1": "500 Howdershell Rd",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630316450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "500 Howdershell Rd",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630316450",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1821 S Stoughton Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537162257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbyrd3315@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "bbyrd3315@direct-ehr-ssmhc.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bbyrd3315@direct-ehr-ssmhc.com",
            "address_1": "1821 S Stoughton Rd",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537162257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "163 E Bethalto Dr",
            "city": "Bethalto",
            "state": "IL",
            "country_code": "US",
            "postal_code": "620101801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.