Individual provider Active NPI

Desirae Leemon

  • Primary Care Nurse Practitioner
  • Danville, IL
National Provider Identifier
1215829098
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
209032714 Issued in IL
Practice address
3545 N Vermilion St
Danville, IL 61832-1100
Phone
(217) 651-6801
NPI assigned
Jul 16, 2025
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 209032714 IL Primary

Addresses

Primary practice location

3545 N Vermilion St
Danville, IL 61832-1100

Mailing address

3545 N Vermilion St
Danville, IL 61832-1100
Phone (217) 641-6801

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
I20250805001626 IL Practitioner - Nurse Practitioner 6901314525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Two Roads Wellness Clinic, LLCGroup PAC ID 9638536220, 9 clinicians

Practice addresses (Care Compare)

3545 N Vermilion St
Danville, IL 61832-1100
Phone (217) 651-6801

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209032714ILMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Two Roads Wellness Clinic, LLC Primary Care CurrentSince Jul 22, 2025 Accepting new patients
Two Roads Wellness Clinic, LLC CurrentSince Jul 22, 2025 Accepting new patients

Locations

3545 N Vermilion St
Danville, IL 61832
Phone (217) 442-8611

Interoperability endpoints

  • Direct secure messaging: desirae.leemon.1@30412.direct.athenahealth.com

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": "1752624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1215829098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3545 N VERMILION ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321100",
            "telephone_number": "217-641-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 N VERMILION ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618321100",
            "telephone_number": "217-651-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEEMON",
        "first_name": "DESIRAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "IL",
            "license": "209032714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

Verify at the official NPI Registry.