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

Mr. Justin Matthew Jefferson

Individual provider Nurse Practitioner · NPI 1073238440

Mr. Justin Matthew Jefferson is a Nurse Practitioner in Urbana, Illinois. Qualified in 2020, 6 years ago. Practices with Carle Health Care Incorporated, a 1,543-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
6
Licensed in
IL
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

611 W Park St
Urbana, IL 61801-2529
Phone: (217) 326-4325
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 209025128 (IL)
Nurse Practitioner Taxonomy 363L00000X · Licence 209.025128 (IL)

Record details

NPI number1073238440
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 7, 2022
Last updated in NPPESMay 5, 2023
Certification dateApril 26, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Carle Health Care Incorporated — 1543 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Urbana