Makayla Bogard, NP-C
Individual provider Active NPI Family Nurse Practitioner · Olney, IL
NPI 1972257681 · NPPES record last updated Nov 8, 2023
Key facts
- NPI
- 1972257681
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209.027522 (IL)
- Practice address
- 800 E Locust St
Olney, IL 62450-2553 - Phone
- (618) 395-2131
- NPI assigned
- Feb 10, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Richland Memorial Hospital Inc
Practice addresses (Care Compare)
800 E Locust St
Olney, IL 62450-2553
Phone (618) 395-7340
Hospital & facility affiliations
- Carle Richland Memorial Hospital
- Lawrence County Memorial Hospital
- Crawford Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230913002300 | IL | Practitioner - Nurse Practitioner | 8123482874 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.027522 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richland Memorial Hospital, Inc | Current |
Accepting new patients | |
| Richland Memorial Hospital, Inc | Current |
Accepting new patients | |
| Richland Memorial Hospital, Inc | Current | Accepting new patients | |
| Womens Health Services of the Cumberlands, PLLC | Past |
Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
101 Industry Rd
Bridgeport, IL 62417
Phone (618) 395-7340
900 E Scott St
Olney, IL 62450
Phone (618) 345-1000
800 E Locust St
Olney, IL 62450
Phone (618) 395-2131
1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194
Interoperability endpoints
- mbogardaprn374137@carlehiedirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.027522 | IL | Yes |
Addresses
Primary practice location
800 E Locust St
Olney, IL 62450-2553
Mailing address
800 E Locust St
Olney, IL 62450-2553
Phone (618) 395-2131
Other providers in Olney, IL
- David R Benson
- Shari Lyn Berger
- Jessica Nichole Berghaus
- Cindy L Birdsall
- Shannon Duane Blank
- Emil Borowiak
- Marissa Bower
- Bowers Drug Store Inc
- Marlissa Boyles
- Brad McMillin, Inc
All providers in Olney, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.