JESSICA NICOLE BOOZER – Family Nurse Practitioner, NPI 1578113759

JESSICA NICOLE BOOZER is a healthcare provider. based in Jacksonville, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. 209019856 (IL). The NPI Number for JESSICA NICOLE BOOZER is 1578113759

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
JESSICA NICOLE BOOZER
NPI
1578113759
Phone
(217) 243-6454
Address
1745 W WALNUT ST
Enumeration Date
18 September 2019
Last Update Date
31 May 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2172859601
Graduation Year
2019 (7 years ago)
PAC ID
8325370364
Group Practice PAC ID
0749192375
Professional Enrollment ID
I20230519001584
Address ID
IL623631412PI320XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:6State licenses:1Digital endpointsOther names

11,632 NURSE PRACTITIONER in IL

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Provider Addresses for JESSICA NICOLE BOOZER

  • 1745, West Walnut Street, Jacksonville, Morgan County, Illinois, 62650, United States

    JACKSONVILLE, IL 626506126

    Phone: (217) 243-6454

    Fax: (217) 243-1388

    Type: Mailing

  • 320 N MADISON ST

    PITTSFIELD, IL 623631412

    Phone: (217) 285-9601

    Type: Mailing

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: 2023-05-19

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
I20230519001584INurse 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 62650)

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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: 0749192375View full group profile

Reviews

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Frequently asked questions

What is JESSICA NICOLE BOOZER's NPI number?
JESSICA NICOLE BOOZER's NPI is 1578113759 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to JESSICA NICOLE BOOZER?
You should see JESSICA NICOLE BOOZER as active in CMS-hosted NPPES data.
How would a patient describe JESSICA NICOLE BOOZER's focus?
For JESSICA NICOLE BOOZER, the primary taxonomy reads as Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for JESSICA NICOLE BOOZER?
Travel planning: use Jacksonville, Illinois as the reference point for JESSICA NICOLE BOOZER, then confirm.
Does JESSICA NICOLE BOOZER accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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