Active NPI
Samantha Robbins, APN
- Family Nurse Practitioner
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209.012037
- Practice address
- 530 NE Glen Oak Ave
Pediatric Diabetes Resource Center
Peoria, IL 61637 - Phone
- (309) 624-2480
- Fax
- (309) 624-2481
- NPI assigned
- Dec 10, 2014
- Last updated
- Dec 10, 2014
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209.012037 | IL | Primary |
| Registered Nurse | 163W00000X | 041.362542 | IL |
Addresses
Primary practice location
530 NE Glen Oak Ave
Pediatric Diabetes Resource Center
Peoria, IL 61637
Mailing address
530 NE Glen Oak Ave
Pediatric Diabetes Resource Center
Peoria, IL 61637
Phone (309) 624-2480
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.362542 | IL | MD | Registered Nurse |
| 209.012037 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
7694 Solutions Ctr
Chicago, IL 60677
1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
530neglen Oak Ave
Peoria, IL 61637
Phone (309) 692-5393
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
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.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
dba Medical Service Plan at Peoria
- Pediatrics Physician
- Peoria, IL
- NPI 1467425322
-
dba Occupational Health Service Institute (OHSI)
- Occupational Medicine Physician
- Chicago, IL
- NPI 1043727571
-
dba patton pharmacy and v&s variety
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418169600000",
"number": "1093113854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 NE GLEN OAK AVE",
"address_2": "PEDIATRIC DIABETES RESOURCE CENTER",
"city": "PEORIA",
"state": "IL",
"postal_code": "61637",
"telephone_number": "309-624-2480",
"fax_number": "309-624-2481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 NE GLEN OAK AVE",
"address_2": "PEDIATRIC DIABETES RESOURCE CENTER",
"city": "PEORIA",
"state": "IL",
"postal_code": "61637",
"telephone_number": "309-624-2480",
"fax_number": "309-624-2481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBBINS",
"first_name": "SAMANTHA",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-10",
"last_updated": "2014-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209.012037",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "IL",
"license": "041.362542",
"primary": false
}
],
"identifiers": [],
"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 Dec 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.