PRISCILLA POORE
NPI 1962108928
Nurse Practitioner in Fairfield, IL

Q: What is Priscilla Poore's NPI number?

The NPI number for Priscilla Poore is 1962108928. It was assigned to this individual provider in the NPPES registry on February 1, 2023.

Q: What is Priscilla Poore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Priscilla Poore was last updated on February 1, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 01, 2023PECOS EnrolledAccepts Medicare Assignment

303 NW 11TH ST, FAIRFIELD, IL 62837(618) 842-4617 Get Directions Write a Review

NPPES record last updated: February 1, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Priscilla Poore NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRISCILLA POORE (NPI 1962108928) is an individual nurse practitioner in Fairfield, Illinois, licensed in Illinois (209026764) and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS, is affiliated with Fairfield Memorial Hospital 1, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1962108928

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NamePRISCILLA POORE

Location Address303 NW 11TH STFairfield, IL 62837-1203

Mailing Address303 Nw 11th StFairfield, IL 62837-1203

Phone(618) 842-4617

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateFebruary 1, 2023

NPPES CertifiedFebruary 1, 2023

✔ NPI 1962108928 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IL · 209026764

Definition

(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.

303 NW 11TH ST, Fairfield, IL 62837

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Priscilla Poore is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5496127789

PECOS Enrollment IDI20230215000382

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Fairfield Memorial Hospital 1

Critical Access Hospitals · Fairfield, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number141311

Location303 N W 11th StreetFairfield, IL 62837 · Wayne County

Emergency services

Hamilton Memorial Hospital

Critical Access Hospitals · Mcleansboro, IL

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number141326

Location611 S Marshall AvenueMcleansboro, IL 62859 · Hamilton County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62837 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WHITNEY ELAINE BUCKLES RD, LDN

Dietitian, Registered