Individual provider Active NPI

Bradee Lynn Aamodt, DNP ACNPC-AG

  • Gerontology Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1336051416
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
209036658 Issued in IL
Practice address
1001 Main St Ste 200
Peoria, IL 61606-2035
Phone
(309) 672-5682
Fax
(309) 672-3147
NPI assigned
Sep 22, 2026
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 209036658 IL Primary

Addresses

Primary practice location

1001 Main St Ste 200
Peoria, IL 61606-2035

Mailing address

1001 Main St Ste 200
Peoria, IL 61606-2035
Phone (309) 672-5682

Other practice location 1

530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 655-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1336051416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE 200",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616062035",
            "telephone_number": "309-672-5682",
            "fax_number": "309-672-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MAIN ST STE 200",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616062035",
            "telephone_number": "309-672-5682",
            "fax_number": "309-672-3147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616370001",
            "country_code": "US",
            "telephone_number": "309-655-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AAMODT",
        "first_name": "BRADEE",
        "middle_name": "LYNN",
        "credential": "DNP ACNPC-AG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209036658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.