Amy Anderson

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

277001779 Issued in IL

Practice address

7717 N Orange Prairie Rd
Peoria, IL 61615-9323

Phone

(309) 589-6800

NPI assigned

May 7, 2019

Last updated

Jan 3, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Danville Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Peoria, IL
  • NPI 1336197284
  NPD
• Molina Healthcare of Illinois, Inc.

  • Health Maintenance Organization
  • Downers Grove, IL
  • NPI 1912538448
  NPD

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

{
    "created_epoch": "1557187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1215592183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PARKWOOD CIR",
            "city": "DAHINDA",
            "state": "IL",
            "postal_code": "614289517",
            "telephone_number": "309-509-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7717 N ORANGE PRAIRIE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159323",
            "telephone_number": "309-589-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "799 N Henderson St",
            "address_purpose": "LOCATION",
            "city": "Galesburg",
            "state": "IL",
            "postal_code": "614012515",
            "country_code": "US",
            "telephone_number": "309-315-4817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-07",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277001779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lizda Linett Anaya Dahud, M.D.
• Freedom Rocillo Andal, AGACNP
• Whitney Renee Andal, APN
• Jeremiah S. Anders
• Megan Emily Andersen, MD
• Bryan Anderson, M.D.
• Christina Anderson, MD
• Clark Anderson, PA-C
• Dean Anderson, RN,C-FNP
• Debra Sue Anderson, PT

• Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; 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.

Verify at the official NPI Registry.