Denise Bungard, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.024462 Issued in IL

Practice address

736 SW Washington St Ste 2a
Peoria, IL 61602-1643

Phone

(309) 497-0300

Fax

(309) 272-0004

NPI assigned

Jan 25, 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

Electronic endpoints 1

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, 2021

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)

Hospital & facility affiliations

• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

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.

• 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
• Ciwirc ( Central Illinois Work Injury Resource Center )

  • Special Hospital
  • Peoria, IL
  • NPI 1508073347
  NPD (past)
• Iwin (Integrated Work Injury Network)

  • Occupational Medicine Clinic/Center
  • Peoria, IL
  • NPI 1679811590
  NPD (past)

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1316699945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20804 N DEER BLUFFS DR",
            "city": "CHILLICOTHE",
            "state": "IL",
            "postal_code": "615239766",
            "telephone_number": "309-573-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "736 SW WASHINGTON ST STE 2A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021643",
            "telephone_number": "309-497-0300",
            "fax_number": "309-272-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUNGARD",
        "first_name": "DENISE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.024462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "IWIRCDR@iwirc.biz",
            "affiliation": "N",
            "endpointDescription": "outlook email- provider inbox",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "736 SW Washington St Ste 2A",
            "city": "Peoria",
            "state": "IL",
            "country_code": "US",
            "postal_code": "616021643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Marilyn Bukoff Priddy, MA, RD, LDN
• Sarah Buley, APN
• Terrin Marie Bull, MD
• Gwynetta Bullock
• Bump Health Inc
• Valerie Bunn
• Janeen Noelle Buonaccorsi, M.D.
• Lisa Jean Burckhartzmeyer, MD
• Meredith Burd
• Jacob Z Burg

• 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 Jan 25, 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.