Individual provider Active NPI

Nicole Lovin, APN-CNP

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1063806412
Registry record updated Apr 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209012675 Issued in IL
Practice address
5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone
(309) 691-1000
NPI assigned
Mar 24, 2015
Last updated
Apr 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209012675 IL Primary

Addresses

Primary practice location

5409 N Knoxville Ave
Peoria, IL 61614-5069

Mailing address

5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000

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
I20150514000235 IL Practitioner - Nurse Practitioner 5890015960 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pekin Memorial Hospital CurrentSince Jun 1, 2015 Accepting new patients
Pekin Memorial Hospital CurrentSince Jun 1, 2015 Accepting new patients
Epss LLC - Central Series CurrentSince Oct 1, 2017 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Epss Peoria LLC CurrentSince May 1, 2015 Accepting new patients

Locations

600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151

5409 N Knoxville Ave
Peoria, IL 61614
Phone (309) 691-1000

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

6300 Ridglea Pl
Ste 201
Ft Worth, TX 76116

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428364800000",
    "number": "1063806412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5409 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145069",
            "telephone_number": "309-691-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5409 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145069",
            "telephone_number": "309-691-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVIN",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2015-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209012675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.