Individual provider Active NPI

Brittany McDonald, APRN

  • Nurse Practitioner
  • Mount Vernon, IL
National Provider Identifier
1962204503
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209032011 Issued in IL
Practice address
3111 Broadway St
Mount Vernon, IL 62864-2338
Phone
(618) 241-0300
NPI assigned
Mar 25, 2025
Last updated
Mar 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209032011 IL Primary

Addresses

Primary practice location

3111 Broadway St
Mount Vernon, IL 62864-2338

Mailing address

PO Box 632331
Cincinnati, OH 45263-2331
Phone (812) 450-0702

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
I20250408000907 IL Practitioner - Nurse Practitioner 7719401157 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2700 W Deyoung St
Marion, IL 62959-4942
Phone (618) 969-8633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209032011ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner CurrentSince May 1, 2025 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner CurrentSince May 1, 2025 Accepting new patients
Deaconess Illinois Specialty Clinic, Inc. Nurse Practitioner Current Accepting new patients
Deaconess Illinois Clinic, Inc Past Accepting new patients

Locations

303 S Commercial St
Harrisburg, IL 62946
Phone (618) 767-6050

2700 W Deyoung St
Marion, IL 62959
Phone (618) 969-8633

3111 Broadway St
Mount Vernon, IL 62864
Phone (618) 241-0300

509 Hamacher St
Waterloo, IL 62298
Phone (618) 939-3939

909 W Main St
West Frankfort, IL 62896
Phone (618) 372-6040

Organizations & group practices 4

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.

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": "1742860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1962204503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632331",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632331",
            "telephone_number": "812-450-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 BROADWAY ST",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642338",
            "telephone_number": "618-241-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "BRITTANY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-25",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209032011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

Verify at the official NPI Registry.