Individual provider Active NPI

Gerri Hellhake-Hall, FNP

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1164439659
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209001303 Issued in IL
Practice address
5405 N Knoxville Ave
Peoria, IL 61614-5016
Phone
(309) 691-4410
NPI assigned
Aug 1, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 209001303 IL Primary

Addresses

Primary practice location

5405 N Knoxville Ave
Peoria, IL 61614-5016

Mailing address

5405 N Knoxville Ave
Peoria, IL 61614-5016
Phone (309) 691-4410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051128000594 IL Practitioner - Nurse Practitioner 5890715478 Reassigns benefits to 1 organization
I20210730002610 KS Practitioner - Nurse Practitioner 5890715478

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Southern Illinois University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graham Hospital AssociationGroup PAC ID 2769375021, shared by 15 NPIs, 124 clinicians

Practice addresses (Care Compare)

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carle West Physician Group Inc CurrentSince Apr 17, 2024 Accepting new patients
Heartcare Midwest Past Accepting new patients

Locations

2204 Eastland Dr
Bloomington, IL 61704
Phone (309) 662-9461

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

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, 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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164439659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-691-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145016",
            "telephone_number": "309-691-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLHAKE-HALL",
        "first_name": "GERRI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209001303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.