Tammy L Osborn, APN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209.030221 Issued in IL

Practice address

702 W Chestnut St
Bloomington, IL 61701-2814

Phone

(309) 557-1400

NPI assigned

Apr 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

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 and National Provider Directory roles.

• Chestnut Health Systems Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Bloomington, IL
  • NPI 1366431686

  IL

  Medicare reassignment NPD
• Chestnut Health Systems Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wood River, IL
  • NPI 1235941311
  NPD

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1245295286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "448 WYLIE DR STE L100",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617615405",
            "telephone_number": "888-924-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W CHESTNUT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617012814",
            "telephone_number": "309-557-1400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Main",
            "address_2": "Suite L100",
            "address_purpose": "LOCATION",
            "city": "East Peoria",
            "state": "IL",
            "postal_code": "61611",
            "country_code": "US",
            "telephone_number": "309-694-6462",
            "fax_number": "309-694-7812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSBORN",
        "first_name": "TAMMY",
        "middle_name": "L",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041315198",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.030221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Optim Dental Bloomington LLC
• Hannah Elizabeth Ortell
• Orthopedic and Sports Enhancement Center, LLC
• Orthopedic Rehabilitation Supply LLC
• Jaclyn A. Orton, LCSW
• Chad Osborne, M.D.
• Osf Healthcare System
• Osf Multi-Specialty Group
• Osf Multi-Specialty Group
• Osf Multispecialty Group - Eastern Region, LLC

• All providers in Bloomington, IL
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.