Individual provider Active NPI

Aaron M Owens, NP

  • Gerontology Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1265070494
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
209020659 Issued in IL
Practice address
112 NE Crescent Ave
Peoria, IL 61606-1901
Phone
(309) 672-4670
NPI assigned
Dec 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209020659 IL
Gerontology Nurse Practitioner 363LG0600X 209020659 IL Primary

Addresses

Primary practice location

112 NE Crescent Ave
Peoria, IL 61606-1901

Mailing address

406 W Fast Ave
Mackinaw, IL 61755-8755

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
I20200317001140 IL Practitioner - Nurse Practitioner 3476981903 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Saint Anthonys Way
Alton, IL 62002-4568
Phone (618) 465-2571

1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120

1800 E Lake Shore Dr
Decatur, IL 62521-3810
Phone (217) 464-2966

2200 E Washington St
Bloomington, IL 61701-4364
Phone (309) 662-5361

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-Illinois Hospitalists CurrentSince Aug 1, 2024 Accepting new patients
Cep America-Illinois Hospitalists, LLP Current Accepting new patients
Cep America-Illinois Hospitalists, LLP CurrentSince Aug 1, 2024 Accepting new patients
Proctor Health Systems CurrentSince Feb 24, 2020 Accepting new patients
Proctor Health Systems CurrentSince Feb 24, 2020 Accepting new patients
Methodist Medical Center of Illinois Acute Care CurrentSince Feb 24, 2020 Accepting new patients
Methodist Medical Center of Illinois CurrentSince Feb 24, 2020 Accepting new patients
Methodist Medical Center of Illinois Current Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1 Saint Elizabeth Blvd
O Fallon, IL 62269
Phone 618234212012438

5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610

112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402

815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1265070494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 W FAST AVE",
            "city": "MACKINAW",
            "state": "IL",
            "postal_code": "617558755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 NE CRESCENT AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616061901",
            "telephone_number": "309-672-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "AARON",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209020659",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209020659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.