DEACONESS IL SPECIALTY EXPRESS BROADWAY ST
NPI 1497462964
Nurse Practitioner in Mount Vernon, IL
NPI Status: Active since November 03, 2022
Contact Information
3111 BROADWAY ST
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 241-0300
Fax: (618) 241-0302
- Organization
- Nurse Practitioner
- Accepts Insurance
About DEACONESS IL SPECIALTY EXPRESS BROADWAY ST
This page provides the complete NPI Profile along with additional information for Deaconess Il Specialty Express Broadway St, a provider established in Mount Vernon, Illinois operating as a Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1497462964 assigned on November 2022. The practitioner's primary taxonomy code is 363L00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. Deaconess Il Specialty Express Broadway St operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Deaconess Il Specialty Express Broadway St. The authorized official of this NPI record is Kyle Dillman (Secretary Treasurer)
- NPI
- 1497462964
- Provider Legal Name
- DEACONESS ILLINOIS SPECIALTY CLINIC, INC.
- Other Organization Name
- DEACONESS IL SPECIALTY EXPRESS BROADWAY ST
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 3111 BROADWAY ST MOUNT VERNON, IL 62864
- Location Phone
- (618) 241-0300
- Location Fax
- (618) 241-0302
- Mailing Address
- PO BOX 34266 BELFAST, ME 04915
- Mailing Phone
- (812) 450-6815
- Mailing Fax
- (618) 241-0302
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-03-2022
- Last Update Date
- 01-26-2023
- Code Navigator
A nurse practitioner (NP) like Deaconess Il Specialty Express Broadway St is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Nurse Practitioner
- Taxonomy Code
- 363L00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- Taxonomy Description
- (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207QS0010X | Allopathic & Osteopathic Physicians | Family Medicine |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 1 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision + Rx Copay - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 9 | 7 | 4 | 6 | 2 | 9 | 6 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 18 | 7 | 8 | 6 | 4 | 9 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 1 + 8 + 7 + 8 + 6 + 4 + 9 + 1 + 2 + 24 = 76 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 76 = 4 | 4 | ||||||||
The NPI number 1497462964 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1558088138 | DEACONESS ILLINOIS CLINIC, INC Organization | Family Medicine | 3111 BROADWAY ST MOUNT VERNON, IL 62864 (618) 241-0300 |
| 1679270763 | DEACONESS ILLINOIS SPECIALTY CLINIC, INC. Organization | Nurse Practitioner (Occupational Health) | 3111 BROADWAY ST MOUNT VERNON, IL 62864 (618) 241-0333 |
| 1932881331 | BRIDGETT NICOLE BROWN FNP-C Individual | Nurse Practitioner | 3111 BROADWAY ST MOUNT VERNON, IL 62864 (618) 241-0333 |
| 1962204503 | BRITTANY MCDONALD APRN Individual | Nurse Practitioner | 3111 BROADWAY ST MOUNT VERNON, IL 62864 (618) 241-0300 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1497462964, enumerated in the NPI registry as an "organization" on November 03, 2022
The provider is located at 3111 Broadway St Mount Vernon, Il 62864 and the phone number is (618) 241-0300
This medical organization specializes in Nurse Practitioner with taxonomy code 363L00000X
The provider might be accepting Accepts: Aetna CVS Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on November 03, 2022. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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