Leslie Suzanne Jones, N.P. - C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209013267 Issued in IL

Practice address

101 Chittyville Rd
Herrin, IL 62948-3552

Phone

(618) 713-5669

Fax

(618) 417-6049

NPI assigned

Aug 13, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Premise Health of Illinois Medical PC

  • Primary Care Clinic/Center
  • Mount Vernon, IL
  • NPI 1427366921
  Medicare reassignment NPD
• St. Mary'S Hospital, Centralia, Illinois

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1770687196
  Medicare reassignment NPD
• Koen Counseling and Wellness Center

  • Mental Health Counselor
  • Herrin, IL
  • NPI 1952050460
  NPD
• Premise Health of Illinois Medical PC

  • Multi-Specialty Clinic/Center
  • Utica, IL
  • NPI 1295518868
  NPD
• St. Mary'S Hospital, Centralia, Illinois

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Centralia, IL
  • NPI 1710105192
  NPD

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

{
    "created_epoch": "1439424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1982070942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CHITTYVILLE RD",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483552",
            "telephone_number": "618-713-5669",
            "fax_number": "618-417-6049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CHITTYVILLE RD",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483552",
            "telephone_number": "618-713-5669",
            "fax_number": "618-417-6049"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4241 State Highway 14",
            "address_purpose": "LOCATION",
            "city": "Christopher",
            "state": "IL",
            "postal_code": "62822",
            "country_code": "US",
            "telephone_number": "618-724-2401",
            "fax_number": "618-724-4628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JONES",
        "first_name": "LESLIE",
        "middle_name": "SUZANNE",
        "credential": "N.P. - C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-13",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041346274",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209013267",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209013267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Javier Muniz, DO, LLC
• Angelina Johnson
• Kelly Jackson Johnson, PA-C
• Melody Johnson, LPN
• Jared Jones
• Mary Kalert, PTA
• Cyril Kamya, M.D
• Derek G Kenneaster, MD
• Debra J Kester, PA-C
• Avery Victoria Ketteman, RBT

• Psychiatric/Mental Health Nurse Practitioner in Herrin, IL
• Providers in Herrin, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.