NPIMap

Organization Active NPI

JD Nimrick PC

Doing business as Premier Healthcare

  • Physical Therapist
  • Peoria, IL
National Provider Identifier
1336150283
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
JD NIMRICK PC
Doing business as
Premier Healthcare
Practice address
3531 W Willow Knolls Dr
Peoria, IL 61614-1078
Phone
(309) 683-6900
Fax
(309) 683-6902
NPI assigned
Aug 10, 2006
Last updated
Mar 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Authorized official

Name
Laura Sherman
Title
Billing Coordinator
Phone
(309) 683-4646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X IL Primary

Addresses

Primary practice location

3531 W Willow Knolls Dr
Peoria, IL 61614-1078

Mailing address

PO Box 3477
Peoria, IL 61612-3477
Phone (309) 683-6900

Other names 1

  • Premier Healthcare Doing business as

National Provider Directory

National Provider Directory

Locations

4422 N Brandywine Dr
Peoria, IL 61614
Phone (309) 686-4422

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1336150283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3477",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616123477",
            "telephone_number": "309-683-6900",
            "fax_number": "309-683-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3531 W WILLOW KNOLLS DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616141078",
            "telephone_number": "309-683-6900",
            "fax_number": "309-683-6902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JD NIMRICK PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "SHERMAN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "309-683-4646"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.