Individual provider Active NPI

Casey Waters, APRN, CNP

  • Family Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1285410829
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209028235 Issued in IL
Practice address
6339 N Big Hollow Rd
Peoria, IL 61615-2907
Phone
(309) 693-3315
Fax
(309) 693-9385
NPI assigned
Sep 7, 2023
Last updated
Jul 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209028235 IL Primary

Addresses

Primary practice location

6339 N Big Hollow Rd
Peoria, IL 61615-2907

Mailing address

298 Chippewa CT
Sparland, IL 61565-9401

Other practice location 1

401 N Main St
Roanoke, IL 61561-7585
Phone (309) 923-2661

Other names 1

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231104000515 IL Practitioner - Nurse Practitioner 4688021165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

435 Maxine Dr
Morton, IL 61550-2498
Phone (309) 266-5405

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint James Hospital CurrentSince Oct 18, 2023 Accepting new patients
Saint James Hospital CurrentSince Oct 18, 2023 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Saint James Hospital Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Oct 18, 2023 Accepting new patients

Locations

435 Maxine Dr
Morton, IL 61550
Phone (309) 263-2424

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

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

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

Organizations & group practices 5

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": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1285410829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 CHIPPEWA CT",
            "city": "SPARLAND",
            "state": "IL",
            "postal_code": "615659401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6339 N BIG HOLLOW RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152907",
            "telephone_number": "309-693-3315",
            "fax_number": "309-693-9385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 N Main St",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "IL",
            "postal_code": "615617585",
            "country_code": "US",
            "telephone_number": "309-923-2661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "CASEY",
        "credential": "APRN, CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209028235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "MILLER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.