Active NPI
Bethany Joy Winfrey Ferguson, FNP-BC
- Family Nurse Practitioner
- Peoria, IL
National Provider Identifier
1235505108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209-013059
- Practice address
- 1800 N Knoxville Ave Ste a
Peoria, IL 61603-3005 - Phone
- (309) 680-7600
- Fax
- (309) 495-8614
- NPI assigned
- Aug 14, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209-013059 | IL | Primary |
Addresses
Primary practice location
1800 N Knoxville Ave Ste a
Peoria, IL 61603-3005
Mailing address
2214 N University St
Peoria, IL 61604-3221
Phone (309) 680-7600
Other practice location 1
2321 N Wisconsin Ave
Peoria, IL 61603-5613
Phone (309) 680-7600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 209-013059 | Other | IL | IL APN LICENSE |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151021001314 | IL | Order and Referring Only - Nurse Practitioner | 5294044830 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Osf Multi-Specialty Group | Past | Accepting new patients | |
| Mendota Community Hospital | Nurse Practitioner | Past | Accepting new patients |
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.
-
dba OSF Medical Group-Mendota
- Family Medicine Physician
- Mendota, IL
- NPI 1407872997
Nurse Practitioner
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785283200000",
"number": "1235505108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2214 N UNIVERSITY ST",
"city": "PEORIA",
"state": "IL",
"postal_code": "616043221",
"telephone_number": "309-680-7600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 N KNOXVILLE AVE STE A",
"city": "PEORIA",
"state": "IL",
"postal_code": "616033005",
"telephone_number": "309-680-7600",
"fax_number": "309-495-8614"
}
],
"practiceLocations": [
{
"address_1": "2321 N Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Peoria",
"state": "IL",
"postal_code": "616035613",
"country_code": "US",
"telephone_number": "309-680-7600",
"fax_number": "309-681-8620",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FERGUSON",
"first_name": "BETHANY",
"middle_name": "JOY WINFREY",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-14",
"last_updated": "2026-07-29",
"certification_date": "2026-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209-013059",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL APN LICENSE",
"identifier": "209-013059",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.