Individual provider Active NPI

Andrea Kay Perkins, FNP

  • Family Nurse Practitioner
  • Lincoln, IL
National Provider Identifier
1972794600
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-006697 Issued in IL
Practice address
100 Stahlhut Dr
Lincoln, IL 62656-5059
Phone
(217) 528-7541
Fax
(217) 528-8962
NPI assigned
Aug 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209-006697 IL Primary

Addresses

Primary practice location

100 Stahlhut Dr
Lincoln, IL 62656-5059

Mailing address

1025 S 6TH St
Springfield, IL 62703-2403
Phone (217) 528-7541

Other names 1

  • Andrea Kay Evans Former name

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
I20070914000665 IL Practitioner - Nurse Practitioner 6901990464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Siu Physicians and Surgeons Inc 316 clinicians

Practice addresses (Care Compare)

751 N Rutledge St
Springfield, IL 62702-4968
Phone (217) 545-8000

Hospital & facility affiliations

  • Memorial Medical Center Hospital, Springfield, IL, CCN 140148
  • Decatur Memorial Hospital Hospital, Decatur, IL, CCN 140135

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209-006697ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Siu Physicians & Surgeons, Inc CurrentSince Jun 3, 2019 Accepting new patients
Board of Trustees of Southern Illinois University Current Accepting new patients
Siu Physicians & Surgeons, Inc CurrentSince Jun 3, 2019 Accepting new patients
Siu Physicians & Surgeons, Inc Past Accepting new patients

Locations

751 N Rutledge St
Springfield, IL 62702
Phone (217) 545-0182

301 N 8th St
Springfield, IL 62701
Phone (217) 545-0003

751 N Rutledge St
Ste 3100
Springfield, IL 62702
Phone (217) 545-8417

751 N Rutledge St
Ste 100
Springfield, IL 62702

Interoperability endpoints

  • Direct secure messaging: andreaperkins@siusm.allscriptsdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1972794600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S 6TH ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541",
            "fax_number": "217-528-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STAHLHUT DR",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626565059",
            "telephone_number": "217-528-7541",
            "fax_number": "217-528-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "ANDREA",
        "middle_name": "KAY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-006697",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "EVANS",
            "middle_name": "KAY",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lincoln, IL

Sources for this page

Verify at the official NPI Registry.