Jacksonville Il Wellness

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

JACKSONVILLE IL WELLNESS

Doing business as

Jacksonville Wellness

Practice address

1521 W Walnut St Ste D
Jacksonville, IL 62650-1153

Phone

(217) 279-5815

Fax

(217) 279-5816

NPI assigned

May 7, 2021

Last updated

May 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Katherine S. O'Neil, FNPNPI 1841479896

Title

Owner

Phone

(217) 204-8081

Specialties & licenses 3

Addresses

Other names 1

• Jacksonville Wellness Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Katherine S O'Neil, FNP-BC

  • Family Nurse Practitioner
  • Springfield, IL
  • NPI 1841479896
  NPD Authorized official

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1922682822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 W COLLEGE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626502216",
            "telephone_number": "217-204-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 W WALNUT ST STE D",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501153",
            "telephone_number": "217-279-5815",
            "fax_number": "217-279-5816"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 E Morgan St",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "IL",
            "postal_code": "626502509",
            "country_code": "US",
            "telephone_number": "217-279-5815",
            "fax_number": "217-279-5816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACKSONVILLE IL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-07",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "O'NEIL",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-204-8081",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jacksonville Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Medical Specialty Clinic/Center in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.