Individual provider Active NPI

Jennifer Lynne Hall, FNP-C

  • Family Nurse Practitioner
  • Mattoon, IL
National Provider Identifier
1902471444
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209022952 Issued in IL
Practice address
1005 Health Center Dr Ste 201
Mattoon, IL 61938-4653
Phone
(217) 258-2409
Fax
(217) 258-2323
NPI assigned
May 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041341686 IL
Nurse Practitioner 363L00000X 209022952 IL
Family Nurse Practitioner 363LF0000X 209022952 IL Primary

Addresses

Primary practice location

1005 Health Center Dr Ste 201
Mattoon, IL 61938-4653

Mailing address

PO Box 372
Mattoon, IL 61938-0372

Other practice location 1

1201 Wooddell Way Ste B
Mattoon, IL 61938-1014
Phone (217) 238-3000

Other practice location 2

1100 Tuscola Blvd
Tuscola, IL 61953-2065
Phone (217) 253-2020

Other practice location 3

1303 W Evergreen Ave Ste 100
Effingham, IL 62401-1638
Phone (217) 540-6123

Other practice location 4

2040 Lincoln Ave Ste 100
Charleston, IL 61920-3197
Phone (217) 345-2030

Other practice location 5

905 N Maple St
Effingham, IL 62401-6401
Phone (217) 347-7077

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
I20210804000935 IL Practitioner - Nurse Practitioner 6002210606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Practice addresses (Care Compare)

1000 Health Ctr Dr
Mattoon, IL 61938-4644

1000 Health Ctr Dr
Suite 401
Mattoon, IL 61938-4648
Phone (217) 258-4020

101 Professional PLZ
Mattoon, IL 61938-9252
Phone (217) 238-3730

1100 Tuscola Blvd
Tuscola, IL 61953-2065
Phone (217) 253-2020

1303 W Evergreen Ave
Effingham, IL 62401-1638

200 Richmond Ave E
Mattoon, IL 61938-4652

905 N Maple St
Effingham, IL 62401-6401
Phone (217) 258-4186

Hospital & facility affiliations

  • Sarah Bush Lincoln Health Center Hospital, Mattoon, IL, CCN 140189

Merit-based Incentive Payment System (MIPS)

Final score
88.96 of 100Reported as apm
Quality
69.5
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041341686ILMDRegistered Nurse
209022952ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah Bush Lincoln Health Center CurrentSince Jun 27, 2022 Accepting new patients
Decatur Memorial Hospital CurrentSince Jul 14, 2021 Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Decatur Memorial Hospital CurrentSince Jul 14, 2021 Accepting new patients
Sarah Bush Lincoln Health Center PastSince May 1, 2022 Accepting new patients

Locations

2040 Lincoln Ave
Ste 100
Charleston, IL 61920
Phone (217) 345-2030

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

101 W McKinley Ave
Decatur, IL 62526
Phone (217) 876-3682

1303 W Evergreen Ave
Ste 100
Effingham, IL 62401
Phone (217) 540-6123

905 N Maple St
Effingham, IL 62401
Phone (217) 347-7077

905 N Maple St
Ste B
Effingham, IL 62401

241 W Weaver Rd
Ste 145B
Forsyth, IL 62535
Phone (217) 876-5220

200 Dettro Dr
Mattoon, IL 61938
Phone (217) 238-3000

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

1005 Health Center Dr
Ste 201
Mattoon, IL 61938
Phone (217) 238-6055

1000 Health Center Dr
Ste 401
Mattoon, IL 61938
Phone (217) 258-2409

1201 Wooddell Way
Ste B
Mattoon, IL 61938
Phone (217) 238-3000

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

1100 Tuscola Blvd
Tuscola, IL 61953
Phone (217) 253-2020

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 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": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1902471444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DR STE 201",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384653",
            "telephone_number": "217-258-2409",
            "fax_number": "217-258-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Wooddell Way Ste B",
            "address_purpose": "LOCATION",
            "city": "Mattoon",
            "state": "IL",
            "postal_code": "619381014",
            "country_code": "US",
            "telephone_number": "217-238-3000",
            "fax_number": "217-238-3008",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Tuscola Blvd",
            "address_purpose": "LOCATION",
            "city": "Tuscola",
            "state": "IL",
            "postal_code": "619532065",
            "country_code": "US",
            "telephone_number": "217-253-2020",
            "fax_number": "217-253-4886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1303 W Evergreen Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624011638",
            "country_code": "US",
            "telephone_number": "217-540-6123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2040 Lincoln Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "IL",
            "postal_code": "619203197",
            "country_code": "US",
            "telephone_number": "217-345-2030",
            "fax_number": "217-345-2045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "905 N Maple St",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624016401",
            "country_code": "US",
            "telephone_number": "217-347-7077",
            "fax_number": "217-347-7197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2024-11-01",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041341686",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209022952",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209022952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.