Individual provider Active NPI

Danielle Schmidgall, APN

  • Family Nurse Practitioner
  • Morton, IL
National Provider Identifier
1154078897
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.024837 Issued in IL
Practice address
435 Maxine Dr
Morton, IL 61550-2498
Phone
(309) 263-8173
NPI assigned
Mar 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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 209.024837 IL Primary

Addresses

Primary practice location

435 Maxine Dr
Morton, IL 61550-2498

Mailing address

730 N Nebraska Ave
Morton, IL 61550-1746
Phone (309) 241-5155

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
I20220404000537 IL Practitioner - Nurse Practitioner 6002202868 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.024837ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Apr 1, 2022 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

435 Maxine Dr
Ste 3
Morton, IL 61550
Phone (309) 263-2424

435 Maxine Dr
Morton, IL 61550
Phone (309) 263-2424

435 Maxine Dr
Ste 4
Morton, IL 61550
Phone (309) 263-2424

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1154078897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N NEBRASKA AVE",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501746",
            "telephone_number": "309-241-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 MAXINE DR",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615502498",
            "telephone_number": "309-263-8173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDGALL",
        "first_name": "DANIELLE",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.024837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

Verify at the official NPI Registry.