Individual provider Active NPI

Tammi Lynn Jones, FNP

  • Family Nurse Practitioner
  • Belleville, IL
National Provider Identifier
1902273717
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209013258 Issued in IL
Practice address
4550 Memorial Dr
Suite 360
Belleville, IL 62226-5372
Phone
(618) 239-9500
NPI assigned
Aug 27, 2015
Last updated
Aug 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209013258 IL Primary

Addresses

Primary practice location

4550 Memorial Dr
Suite 360
Belleville, IL 62226-5372

Mailing address

4550 Memorial Dr
Suite 360
Belleville, IL 62226-5372
Phone (618) 239-9500

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
I20151001003027 IL Practitioner - Nurse Practitioner 9032427596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rashid a Dalal MD PCGroup PAC ID 2163459348, 5 clinicians

Practice addresses (Care Compare)

12860 Troxler Ave
Suite 120
Highland, IL 62249-2898
Phone (618) 239-9500

129 N 8TH St
E Saint Louis, IL 62201-2917
Phone (618) 274-1900

129 N Eight St 3Rd FL
E Saint Louis, IL 62201-2917
Phone (618) 482-7050

2061 Goose Lake Rd
Sauget, IL 62206-2822
Phone (618) 332-7801

2071 Goose Lake Rd
Sauget, IL 62206-2822
Phone (618) 239-9500

2130 Vadalabene Dr
Maryville, IL 62062-5632
Phone (618) 288-0703

5003 N Illinois St
Suite 1
Fairview Heights, IL 62208-3419
Phone (618) 239-9500

5105 W Main St
Belleville, IL 62226-4728
Phone (618) 239-9500

9 American VLG
Granite City, IL 62040-3706
Phone (618) 452-5858

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209013258ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rashid a Dalal MD PC CurrentSince Aug 31, 2015 Accepting new patients

Locations

4550 Memorial Dr
Ste 360
Belleville, IL 62226
Phone (618) 222-5999

129 N 8th St
East Saint Louis, IL 62201
Phone (617) 274-1905

5003 N Illinois St
#1
Fairview Heights, IL 62208
Phone (618) 235-5945

12860 Troxler Ave
Ste 120
Highland, IL 62249
Phone (618) 664-9831

Interoperability endpoints

  • Direct secure messaging: tammi.jones@direct.davitaphysiciansolutions.com

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440633600000",
    "number": "1902273717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "SUITE 360",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265372",
            "telephone_number": "618-239-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "SUITE 360",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265372",
            "telephone_number": "618-239-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "TAMMI",
        "middle_name": "LYNN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belleville, IL

Sources for this page

Verify at the official NPI Registry.