Individual provider Active NPI

Jennifer T Behrens, MD

  • Emergency Medicine Physician
  • Urbana, IL
National Provider Identifier
1992737563
Registry record updated Oct 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036146322 Issued in IL
Practice address
611 W Park St
Urbana, IL 61801-2529
Phone
(217) 383-3313
Fax
(217) 383-4014
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 01063671A IN
Emergency Medicine Physician 207P00000X 036146322 IL Primary

Addresses

Primary practice location

611 W Park St
Urbana, IL 61801-2529

Mailing address

611 W Park St
Urbana, IL 61801-2529

Other identifiers 3

IdentifierTypeStateIssuer
2683618MedicaidOH
000000604753OtherANTHEM
200938340MedicaidIN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181109001959 IL Practitioner - Emergency Medicine 2163425349 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036146322ILMDEmergency Medicine Physician
01063671AINMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kirby Medical Center CurrentSince Oct 23, 2018 Accepting new patients
Kirby Medical Center CurrentSince Jan 3, 2026 Accepting new patients
Kirby Medical Center CurrentSince Oct 23, 2018 Accepting new patients
Carle Health Care Incorporated Emergency Medicine CurrentSince Oct 23, 2018 Accepting new patients
Greene Emergency Medical Services Past Accepting new patients
Reid Hospital & Health Care Services Inc Past Accepting new patients

Locations

1000 Medical Center Dr
Monticello, IL 61856
Phone (217) 762-1540

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: jbehrensmd262934@carlehiedirect.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1992737563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012529",
            "telephone_number": "217-383-3313",
            "fax_number": "217-383-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHRENS",
        "first_name": "JENNIFER",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01063671A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036146322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2683618",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000604753",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200938340",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.