Jamie Lyn Mabry, APN/CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209006061 Issued in IL

Practice address

201 S 14TH St
Herrin, IL 62948-3631

Phone

(618) 942-2171

NPI assigned

Aug 1, 2006

Last updated

May 20, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

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.

• Family Healthcare Clinic & Rehab

  • Rural Health Clinic/Center
  • Harrisburg, IL
  • NPI 1215944152
  NPD (past)

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1902812688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S 14TH ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483631",
            "telephone_number": "618-942-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S 14TH ST",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483631",
            "telephone_number": "618-942-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY",
        "first_name": "JAMIE",
        "middle_name": "LYN",
        "credential": "APN/CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209006061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00428389",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Logan Primary Care Service Corporation
• Craig Michael Logan, LSW
• Jessica Lohman, NP
• Timothy J Loughran, D.D.S
• Joshua Caleb Loyd, FNP-BC
• Mackmalter Enterprises, Inc. (Alpha Home Health Care)
• Rhett A Macneille, MD
• Abdul Rashid Majid, M.D.
• Rachael Victoria Malawy, BCBA
• Ismail Oladeji Malik, M.D.

• Family Nurse Practitioner in Herrin, IL
• Providers in Herrin, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.