Andrea Celeste Blackwell

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209023881 Issued in IL

Practice address

221 NE Glen Oak Ave
Labor and Delivery
Peoria, IL 61636-0001

Phone

(309) 241-6898

NPI assigned

May 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Andrea Celeste Mueller Former name

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

Specialty

Nurse Practitioner

Education

Other, 2020

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)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

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.

• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD

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

{
    "created_epoch": "1652486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652486400000",
    "number": "1295472900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14150 N LAKE WINDERMERE RD",
            "city": "TREMONT",
            "state": "IL",
            "postal_code": "615689287",
            "telephone_number": "309-214-1382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "address_2": "LABOR AND DELIVERY",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-241-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "ANDREA",
        "middle_name": "CELESTE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-14",
        "last_updated": "2022-05-14",
        "certification_date": "2022-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "MUELLER",
            "middle_name": "CELESTE",
            "prefix": "MISS",
            "credential": "MSN, APRN, FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Krey Bixby, OD
• Cheryl Bjerke, LCPC
• Black Women Invest Too LLC
• Baylee Blackburn, DO
• Amy Blackmore, LCSW
• Thomas Blackwell Jr., MD
• Carol Ann Blaha, LCPC
• Jessica Blair, PA
• Patricia Blair, CRNA
• Scott Blank, M.S., R.D., L.D.N.

• Family Nurse Practitioner in Peoria, IL
• Providers in Peoria, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.