Individual provider Active NPI

Brandy J Coleman, APRN

  • Family Nurse Practitioner
  • East Peoria, IL
National Provider Identifier
1376297937
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209024829 Issued in IL
Practice address
133 Spinder Dr
East Peoria, IL 61611-0016
Phone
(309) 308-5100
NPI assigned
Feb 11, 2022
Last updated
Mar 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209024829 IL Primary

Addresses

Primary practice location

133 Spinder Dr
East Peoria, IL 61611-0016

Mailing address

1731 Fairside Dr
Sandwich, IL 60548-1461
Phone (815) 764-9724

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bcoleman255817@direct.edward.org Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20221011002153 IL Practitioner - Nurse Practitioner 7911373220 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1 E County Line Rd
Sandwich, IL 60548-2178
Phone (815) 786-2722

2650 Ridge Ave
Evanston, IL 60201-1700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209024829ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Edward Health Ventures CurrentSince Jan 23, 2023 Accepting new patients
Edward Health Ventures CurrentSince Jan 23, 2023 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Jul 13, 2023 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

6701 US Highway 34
Oswego, IL 60543
Phone (630) 646-4200

1 E County Line Rd
Sandwich, IL 60548
Phone (815) 786-2722

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679616000000",
    "number": "1376297937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 FAIRSIDE DR",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605481461",
            "telephone_number": "815-764-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 SPINDER DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616110016",
            "telephone_number": "309-308-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "BRANDY",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-11",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209024829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcoleman255817@direct.edward.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1 E County Line Rd",
            "city": "Sandwich",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605482178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Peoria, IL

Sources for this page

Verify at the official NPI Registry.