Individual provider Active NPI

Ashley N Perreault, NP-C

  • Family Nurse Practitioner
  • Kankakee, IL
National Provider Identifier
1033699509
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209018073 Issued in IL
Practice address
500 N Wall St Ste C100
Kankakee, IL 60901-2942
Phone
(844) 404-4787
Fax
(815) 936-3243
NPI assigned
Aug 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041408316 IL
Family Nurse Practitioner 363LF0000X 209018073 IL Primary

Addresses

Primary practice location

500 N Wall St Ste C100
Kankakee, IL 60901-2942

Mailing address

500 N Wall St Ste C100
Kankakee, IL 60901-2942
Phone (844) 404-4787

Other practice location 1

1490 E Walnut St Ste A
Watseka, IL 60970-1806
Phone (815) 432-7693

Other names 1

  • Ms. Ashley N Parks Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aperreault7610@Direct.riversidehealthcare.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181105001619 IL Practitioner - Nurse Practitioner 0446503668 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Health SystemGroup PAC ID 3274434717, 202 clinicians

Practice addresses (Care Compare)

500 N Wall St
Kankakee, IL 60901-2942
Phone (844) 404-4787

Hospital & facility affiliations

  • Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
041408316ILMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Health System CurrentSince Nov 2, 2018 Accepting new patients
Riverside Health System CurrentSince Nov 2, 2018 Accepting new patients

Locations

300 Riverside Dr
Ste 2100
Bourbonnais, IL 60914
Phone (815) 928-9666

500 N Wall St
Kankakee, IL 60901
Phone (815) 937-9300

500 N Wall St
Ste C100
Kankakee, IL 60901
Phone (844) 404-4787

1490 E Walnut St
Ste A
Watseka, IL 60970
Phone (815) 432-7693

105 S First St
Wilmington, IL 60481
Phone (815) 476-5210

Interoperability endpoints

  • Direct secure messaging: aperreault7610@direct.riversidehealthcare.net

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1033699509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N WALL ST STE C100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012942",
            "telephone_number": "844-404-4787",
            "fax_number": "815-936-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N WALL ST STE C100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012942",
            "telephone_number": "844-404-4787",
            "fax_number": "815-936-3243"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1490 E Walnut St Ste A",
            "address_purpose": "LOCATION",
            "city": "Watseka",
            "state": "IL",
            "postal_code": "609701806",
            "country_code": "US",
            "telephone_number": "815-432-7693",
            "fax_number": "815-936-7228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERREAULT",
        "first_name": "ASHLEY",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041408316",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209018073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aperreault7610@Direct.riversidehealthcare.net",
            "affiliation": "N",
            "endpointDescription": "Direct, Secure Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 N Wall St Ste C100",
            "city": "Kankakee",
            "state": "IL",
            "country_code": "US",
            "postal_code": "609012942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "PARKS",
            "middle_name": "N",
            "prefix": "MS.",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.