Individual provider Active NPI

Alyssa R. Loepker, FNP-C

  • Family Nurse Practitioner
  • Highland, IL
National Provider Identifier
1992194401
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-012494 Issued in IL
Practice address
1212 Broadway
Highland, IL 62249-1960
Phone
(618) 651-0022
Fax
(618) 651-0023
NPI assigned
Jan 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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 209-012494 IL Primary

Addresses

Primary practice location

1212 Broadway
Highland, IL 62249-1960

Mailing address

6810 State Route 162
Box 215
Maryville, IL 62062
Phone (618) 391-6495

Other practice location 1

6812 State Route 162 Ste 120
Maryville, IL 62062-8586
Phone (618) 288-0044

Other practice location 2

1215 Vandalia Avenue
Collinsville, IL 62234
Phone (618) 343-6015

Other names 1

  • Alyssa R Mueth 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
I20150326000212 IL Practitioner - Nurse Practitioner 1557688868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

6812 State Route 162
Suite 120
Maryville, IL 62062-8586
Phone (618) 288-0044

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.76 of 100Reported as group
Quality
54.98
Promoting interoperability
85
Improvement activities
40
Cost
73.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-012494ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Medical Group, LLC CurrentSince Sep 28, 2020 Accepting new patients

Locations

1212 Broadway
Highland, IL 62249
Phone (618) 651-0022

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

6812 State Route 162
Ste 120
Maryville, IL 62062
Phone (618) 288-0044

Organizations & group practices 1

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 4

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": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1992194401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 STATE ROUTE 162",
            "address_2": "BOX 215",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "62062",
            "telephone_number": "618-391-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 BROADWAY",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "622491960",
            "telephone_number": "618-651-0022",
            "fax_number": "618-651-0023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6812 State Route 162 Ste 120",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620628586",
            "country_code": "US",
            "telephone_number": "618-288-0044",
            "fax_number": "618-288-0066",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1215 Vandalia Avenue",
            "address_purpose": "LOCATION",
            "city": "Collinsville",
            "state": "IL",
            "postal_code": "62234",
            "country_code": "US",
            "telephone_number": "618-343-6015",
            "fax_number": "618-343-6028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOEPKER",
        "first_name": "ALYSSA",
        "middle_name": "R.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-012494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "MUETH",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highland, IL

Sources for this page

Verify at the official NPI Registry.