Elizabeth Patricia Mincy, APRN-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209007561 Issued in IL

Practice address

2044 Madison Ave
Suite 15
Granite City, IL 62040-4641

Phone

(618) 451-1500

Fax

(618) 451-9484

NPI assigned

May 27, 2009

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

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Ahs Il Medical Group LLCGroup PAC ID 5496111676, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gateway Regional Medical Center Hospital, Granite City, IL, CCN 140125

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elizabeth.mincy.1@28328.direct.athenahealth.com

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.

• Ahs Il Medical Group LLC

  • Clinic/Center
  • Granite City, IL
  • NPI 1659098101
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• American Healthcare Systems Illinois LLC

  • General Acute Care Hospital
  • Granite City, IL
  • NPI 1326765884
  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  dba Gateway Urgent Care

  • Urgent Care Clinic/Center
  • Glen Carbon, IL
  • NPI 1700586344

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  dba Edwardsville Health Center

  • Clinic/Center
  • Edwardsville, IL
  • NPI 1760182307

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  dba Gateway Imaging: Waterloo

  • Clinic/Center
  • Waterloo, IL
  • NPI 1770283301

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  dba Gateway Urgent Care

  • Urgent Care Clinic/Center
  • Columbia, IL
  • NPI 1982304523

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1922233576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2044 MADISON AVE",
            "address_2": "SUITE 15",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404641",
            "telephone_number": "618-451-1500",
            "fax_number": "618-451-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2044 MADISON AVE",
            "address_2": "SUITE 15",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404641",
            "telephone_number": "618-451-1500",
            "fax_number": "618-451-9484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINCY",
        "first_name": "ELIZABETH",
        "middle_name": "PATRICIA",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-27",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209007561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mohammad R Ashraf MD
• Robert Montgomery
• Stacy Renae Moody, DMD
• Jillian L Moreno, HIS
• Emily Mouyard

• Adult Health Nurse Practitioner in Granite City, IL
• Providers in Granite City, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.