Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jordan Kelly Mandeville

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1972387504

Jordan Kelly Mandeville is a Nurse Practitioner in Springfield, Illinois. Qualified in 2023, 3 years ago. Practices with Killian and Associates SC, a 9-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2023
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Practice location Address checks out

3901 Pintail Dr Ste A
Springfield, IL 62711-6768
Phone: (217) 544-3143
Fax: (217) 544-4436
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 209028150 (IL)

Record details

NPI number1972387504
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 23, 2023
Last updated in NPPESJune 26, 2026
Certification dateJune 26, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Killian And Associates Sc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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