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

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1285469148

Retunda Jackson- Phiffer is a Nurse Practitioner in Granite City, Illinois. Qualified in 2024, 2 years ago. Practices with Optimum Mental Health Healing, a 3-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Illinois.

Years since qualifying
2
Licensed in
IL
In the registry since
2024
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Practice location Address checks out

2166 Madison Ave
Granite City, IL 62040-4700
Phone: (618) 452-3301
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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 209030994 (IL)

Record details

NPI number1285469148
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 2, 2024
Last updated in NPPESNovember 6, 2024
Certification dateNovember 6, 2024
Mailing address201 Todd Ln, Belleville, IL 62221-5751

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Optimum Mental Health Healing — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Granite City