Individual provider Active NPI

Jessica Schlupp, FNP

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1184113318
Registry record updated May 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209017528 Issued in IL
Practice address
900 Main St Ste 210
Peoria, IL 61602-5005
Phone
(309) 672-4582
NPI assigned
May 3, 2018
Last updated
May 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2018

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 209017528 IL Primary

Addresses

Primary practice location

900 Main St Ste 210
Peoria, IL 61602-5005

Mailing address

900 Main St Ste 210
Peoria, IL 61602-5005
Phone (309) 672-4582

Other identifiers 1

IdentifierTypeStateIssuer
209017528OtherILLICENSE

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
I20180720003021 IL Practitioner - Nurse Practitioner 5890042857 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Methodist Medical Center of IllinoisGroup PAC ID 1355259714, shared by 8 NPIs, 387 clinicians
Carle Health Care IncorporatedGroup PAC ID 3577515774, 1,592 clinicians

Practice addresses (Care Compare)

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

221 NE Glen Oak Ave
Peoria, IL 61636-0001

600 S 13TH St
Pekin, IL 61554-4936

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

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proctor Health Systems CurrentSince Jun 25, 2018 Accepting new patients
Carle Health Medical Group CurrentSince Jan 1, 2026 Accepting new patients
Methodist Medical Center of Illinois Family CurrentSince Jun 25, 2018 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Jun 25, 2018 Accepting new patients
Proctor Health Systems CurrentSince Jun 25, 2018 Accepting new patients
Pekin Prohealth Inc CurrentSince Jun 25, 2018 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients

Locations

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

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 696-9857

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

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

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

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 671-3000

900 Main St
Ste 210
Peoria, IL 61602
Phone (224) 522-9945

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

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.

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": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525305600000",
    "number": "1184113318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 210",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616025005",
            "telephone_number": "309-672-4582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST STE 210",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616025005",
            "telephone_number": "309-672-4582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHLUPP",
        "first_name": "JESSICA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2018-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209017528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "209017528",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.