Individual provider Active NPI

Bethany Ann Bradley, CNM

  • Advanced Practice Midwife
  • Bloomington, IL
National Provider Identifier
1235022542
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209032242 Issued in IL
Practice address
2111 E Oakland Ave Ste B
Bloomington, IL 61701-5783
Phone
(309) 808-3068
NPI assigned
Jun 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209032242 IL Primary

Addresses

Primary practice location

2111 E Oakland Ave Ste B
Bloomington, IL 61701-5783

Mailing address

8406 Coral Rd
Wonder Lake, IL 60097-9434
Phone (815) 404-0321

Other names 1

  • Bethany Ann Romero Former name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250718001414 IL Practitioner - Certified Nurse Midwife (CNM) 5092221929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

2500 W Reynolds St
Pontiac, IL 61764-9774

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
209032242ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jul 10, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

2111 E Oakland Ave
Ste B
Bloomington, IL 61701
Phone (309) 531-3012

845 S Route 51
Forsyth, IL 62535
Phone (217) 872-0953

602 Woodlawn Rd
Lincoln, IL 62656
Phone (217) 651-8270

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

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

2500 W Reynolds St
Ste 207203205206
Pontiac, IL 61764

2500 W Reynolds St
Pontiac, IL 61764
Phone (815) 842-2828

1405 W Park St
Ste 302
Urbana, IL 61801
Phone (217) 337-2010

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": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1235022542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8406 CORAL RD",
            "city": "WONDER LAKE",
            "state": "IL",
            "postal_code": "600979434",
            "telephone_number": "815-404-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 E OAKLAND AVE STE B",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015783",
            "telephone_number": "309-808-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "BETHANY",
        "middle_name": "ANN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209032242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "ROMERO",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.