Individual provider Active NPI

Cheryl Herrmann

  • Clinical Nurse Specialist
  • Peoria, IL
National Provider Identifier
1063936573
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
209001420 Issued in IL
Practice address
112 NE Crescent Ave
Peoria, IL 61606-1901
Phone
(309) 672-4670
NPI assigned
Jul 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 209001420 IL Primary

Addresses

Primary practice location

112 NE Crescent Ave
Peoria, IL 61606-1901

Mailing address

112 NE Crescent Ave
Peoria, IL 61606-1901
Phone (309) 672-4670

Other identifiers 1

IdentifierTypeStateIssuer
209001420OtherILIL LICENSE

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
I20170818001709 IL Practitioner - Certified Clinical Nurse Specialist (CNS) 9032481486 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, shared by 8 NPIs, 387 clinicians

Practice addresses (Care Compare)

112 NE Crescent Ave
Peoria, IL 61606-1901
Phone (309) 672-4670

112 Necrescent Ave
Peoria, IL 61606-1901
Phone (309) 672-4670

221 NE Glen Oak
Peoria, IL 61636-0001
Phone (309) 672-5522

611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753

Hospital & facility affiliations

  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209
  • Carle Health Proctor Hospital Hospital, Peoria, IL, CCN 140013
  • Carle Health Pekin Hospital Hospital, Pekin, IL, CCN 140120

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems CurrentSince Jul 2, 2017 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients
Carle Health Care Incorporated CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jul 2, 2017 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jul 2, 2017 Accepting new patients
Proctor Health Systems CurrentSince Jul 2, 2017 Accepting new patients

Locations

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

5401 N Knoxville Ave
Ste 207
Peoria, IL 61614
Phone (309) 672-4640

120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519

5401 N Knoxville Ave
Ste 217
Peoria, IL 61614
Phone (309) 282-1864

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

Interoperability endpoints

  • Direct secure messaging: cherrmannaprn388482@carlehiedirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063936573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 NE CRESCENT AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061901",
            "telephone_number": "309-672-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 NE CRESCENT AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061901",
            "telephone_number": "309-672-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMANN",
        "first_name": "CHERYL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IL",
            "license": "209001420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE",
            "identifier": "209001420",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.