Michele Lynn Mounce, CNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

209012995 Issued in IL

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-0001

Phone

(309) 655-3000

NPI assigned

Aug 31, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Michele Lynn Cusack Former name

Medicare fee-for-service enrollment

Enrolled in IL, WA2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2015

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

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmounce605101@direct.peacehealth.org

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
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1023285756

  Nurse Practitioner

  Medicare reassignment NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1508023789
  NPD
• South Sound Inpatient Physicians, PLLC

  • Hospitalist Physician
  • Coupeville, WA
  • NPI 1982035754
  NPD

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1366819971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 HEATHERVIEW DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "61611",
            "telephone_number": "309-655-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616370001",
            "telephone_number": "309-655-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUNCE",
        "first_name": "MICHELE",
        "middle_name": "LYNN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61333948",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.012995",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209012995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "CUSACK",
            "middle_name": "LYNN",
            "credential": "CNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mosaic
• Colleen Moser, PT
• Gregory T Moskop, MD
• Gregory John Motzkus, DO
• Kendra Moultrie-Belk, LCPC
• Cameron Mouro, M.D.
• Erin Elizabeth Mowers, MD, PHD
• Megan N Mowery, APRN, CNP
• Julie D Moza, DEVL THERAPIST
• Paul John Mroz, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.