JEREMY ELLIOTT – Family Nurse Practitioner, NPI 1003416546
Family Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for JEREMY ELLIOTT
PO BOX 19248
SPRINGFIELD, IL 627949248
Phone:
Type: Mailing
1025 S 6TH ST
SPRINGFIELD, IL 627032499
Phone: (217) 528-7541
Type: Location
115 WHITE HALL ST
PATTERSON, IL 620781011
Phone: (217) 691-0364
Type: Mailing
116A N MAIN ST
WHITE HALL, IL 620921054
Phone: (217) 374-2188
Type: Location
116A N Main St
White Hall, IL 620921054
Phone: (217) 374-2188
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2020-11-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20201125000758 | I | Nurse Practitioner | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62794)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Internal Medicine | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Diagnostic Radiology | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | IL |
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