Active NPI
Barbara J Nall, APN
- Women's Health Nurse Practitioner
- Peoria, IL
National Provider Identifier
1053383471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 209002307
- Practice address
- 5401 N Knoxville Ave
Suite 308
Peoria, IL 61614-5098 - Phone
- (309) 692-5100
- Fax
- (309) 692-1400
- NPI assigned
- Feb 2, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 209-002307 | IL | |
| Women's Health Nurse Practitioner | 363LW0102X | 209002307 | IL | Primary |
Addresses
Primary practice location
5401 N Knoxville Ave
Suite 308
Peoria, IL 61614-5098
Mailing address
5401 N Knoxville Ave
Suite 308
Peoria, IL 61614-5098
Phone (309) 692-5100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NAL1-0428-3835 | Other | IL | CERT OF WHC NP |
| 041-180296 | Other | IL | RN LICENSE |
| 209-002307 | Other | IL | APN LICENSE |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209-002307 | IL | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Planned Parenthood of Illinois | Past | Accepting new patients | |
| Planned Parenthood of Illinois | 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.
-
- Clinic/Center
- Pekin, IL
- NPI 1346656279
-
- Clinic/Center
- Chicago, IL
- NPI 1790754745
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312329600000",
"number": "1053383471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5401 N KNOXVILLE AVE",
"address_2": "SUITE 308",
"city": "PEORIA",
"state": "IL",
"postal_code": "616145098",
"telephone_number": "309-692-5100",
"fax_number": "309-692-1400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 N KNOXVILLE AVE",
"address_2": "SUITE 308",
"city": "PEORIA",
"state": "IL",
"postal_code": "616145098",
"telephone_number": "309-692-5100",
"fax_number": "309-692-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NALL",
"first_name": "BARBARA",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-02",
"last_updated": "2011-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "IL",
"license": "209-002307",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "IL",
"license": "209002307",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERT OF WHC NP",
"identifier": "NAL1-0428-3835",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "041-180296",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APN LICENSE",
"identifier": "209-002307",
"state": "IL"
}
],
"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 Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.