MS. FABIENNE NADEEN WITHERSPOON (NP-C) – Family Nurse Practitioner, NPI 1053734004

MS. FABIENNE NADEEN WITHERSPOON (NP-C) is a healthcare provider. based in Georgetown, Illinois. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. 209009867 (IL). The NPI Number for MS. FABIENNE NADEEN WITHERSPOON (NP-C) is 1053734004

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
MS. FABIENNE NADEEN WITHERSPOON (NP-C)
NPI
1053734004
Phone
(217) 274-6966
Address
712 N MAIN ST
Enumeration Date
28 January 2014
Last Update Date
7 May 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7752873290
Graduation Year
2012 (14 years ago)
PAC ID
6305144932
Group Practice PAC ID
5799129730
Professional Enrollment ID
I20180529002423
Address ID
IL619241038CH400XXAVEX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

Provider Addresses for MS. FABIENNE NADEEN WITHERSPOON (NP-C)

  • 712 N MAIN ST

    GEORGETOWN, IL 618461440

    Phone: (217) 274-6966

    Fax: (217) 601-2133

    Mailing address matches the actual address.

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: 2018-05-29

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180529002423INurse PractitionerILTBD

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.

Verify on CMS Revalidation Lookup Tool

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 61846)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799129730View full group profile
NameSpecialtyState
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Internal MedicineNJ
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerMD

Reviews

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Frequently asked questions

What NPI should I save for MS. FABIENNE NADEEN WITHERSPOON (NP-C)?
Save NPI 1053734004 if you need a stable reference for MS. FABIENNE NADEEN WITHERSPOON (NP-C).
Is MS. FABIENNE NADEEN WITHERSPOON (NP-C)'s NPI currently valid?
The extract we use shows MS. FABIENNE NADEEN WITHERSPOON (NP-C) as active.
Does MS. FABIENNE NADEEN WITHERSPOON (NP-C) list a primary specialty?
If you are matching referrals, note Family Nurse Practitioner for MS. FABIENNE NADEEN WITHERSPOON (NP-C). Clinical services aligned with this taxonomy classification.
Does MS. FABIENNE NADEEN WITHERSPOON (NP-C) practice in Illinois?
You will see Georgetown, Illinois on file for MS. FABIENNE NADEEN WITHERSPOON (NP-C) alongside any extra practice locations.
What if Georgetown, Illinois seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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