Individual provider Active NPI

Colleen Susanne Cushing Ragon, APN, CNS

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1073804217
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.013583 Issued in IL
Practice address
5401 N Knoxville Ave
Peoria, IL 61614-5098
Phone
(309) 691-1069
NPI assigned
Apr 21, 2011
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.013583 IL Primary
Adult Health Clinical Nurse Specialist 364SA2200X 209.008764 IL

Addresses

Primary practice location

5401 N Knoxville Ave
Peoria, IL 61614-5098

Mailing address

8940 N Wood Sage Rd
Peoria, IL 61615-7822
Phone (309) 243-3000

Other identifiers 1

IdentifierTypeStateIssuer
209.013583OtherILLICENSE

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
I20130405000061 IL Practitioner - Nurse Practitioner 4981849387 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.013583ILMDFamily Nurse Practitioner
209.008764ILMDAdult Health Clinical Nurse Specialist

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 Jan 16, 2013 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jun 12, 2024 Accepting new patients
Saint Francis Medical Center Past Accepting new patients

Locations

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

5401 N Knoxville Ave
Peoria, IL 61614
Phone (309) 692-1496

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

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

Organizations & group practices 7

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": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1073804217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8940 N WOOD SAGE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-3000",
            "fax_number": "309-243-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145098",
            "telephone_number": "309-691-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSHING RAGON",
        "first_name": "COLLEEN",
        "middle_name": "SUSANNE",
        "name_prefix": "Ms.",
        "credential": "APN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-21",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.013583",
            "primary": true
        },
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "IL",
            "license": "209.008764",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "209.013583",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.