Jennifer Michelle Mazanek

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209035018 Issued in IL

Practice address

1003 E McCord St
Centralia, IL 62801-3345

Phone

(618) 436-6633

NPI assigned

Feb 17, 2026

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, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Mary'S Hospital -Centralia Hospital, Centralia, IL, CCN 140034

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Physician Services Corporation of Southern Illinois Inc.

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  Medicare reassignment

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

• St Mary'S Hospital, Centralia, Illinois

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation

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

{
    "created_epoch": "1771286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1922951219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 E MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013345",
            "telephone_number": "618-436-6633",
            "fax_number": "618-436-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 E MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013345",
            "telephone_number": "618-436-6633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZANEK",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-17",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209035018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Martinez-Uribe
• Nicole Danielle Masaracchia
• Dana Lee Mathis, D.C.
• Robin Lynn Matthews, CADC
• Destin Lloyd Mays, LCSW, ACSW
• Carol Lynn McCrary
• Bettina McCulloch, MSW
• Martell McDaniel
• Angie Kay McDuffie
• Rebecca Lynn McElhose, DNP

• Nurse Practitioner in Centralia, IL
• Providers in Centralia, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2026; 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.