NPIMap

Individual provider Active NPI

Sheri K Buskirk, RN

  • Registered Nurse
  • Peoria, IL
National Provider Identifier
1003990839
Registry record updated Apr 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041302966 Issued in IL
Practice address
515 NE Glen Oak
Suite 105
Peoria, IL 61603-3167
Phone
(309) 674-2002
Fax
(309) 624-9898
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041302966 IL Primary

Addresses

Primary practice location

515 NE Glen Oak
Suite 105
Peoria, IL 61603-3167

Mailing address

515 NE Glen Oak
Suite 105
Peoria, IL 61603-3167
Phone (309) 674-2002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041302966ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel M Couri LTD Past Accepting new patients
Illinois Cardiac Surgery Associates SC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397088000000",
    "number": "1003990839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 NE GLEN OAK",
            "address_2": "SUITE 105",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033167",
            "telephone_number": "309-674-2002",
            "fax_number": "309-624-9898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 NE GLEN OAK",
            "address_2": "SUITE 105",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033167",
            "telephone_number": "309-674-2002",
            "fax_number": "309-624-9898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSKIRK",
        "first_name": "SHERI",
        "middle_name": "K",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2014-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041302966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.