Individual provider Active NPI

Kerri Jean Schafer, APN

  • Family Nurse Practitioner
  • East Peoria, IL
National Provider Identifier
1417401985
Registry record updated Nov 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209-014593 Issued in IL
Practice address
133 Spinder Dr
East Peoria, IL 61611-0016
Phone
(309) 308-5100
Fax
(309) 308-5102
NPI assigned
Aug 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2019

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 209-014593 IL Primary

Addresses

Primary practice location

133 Spinder Dr
East Peoria, IL 61611-0016

Mailing address

PO Box 960347
Oklahoma City, OK 73196-0347
Phone (309) 672-5522

Other practice location 1

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5522

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
I20160902002072 IL Practitioner - Nurse Practitioner 7012203847 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2016
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)

8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209-014593ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Jul 28, 2019 Accepting new patients
Methodist Medical Center of Illinois Family CurrentSince Aug 1, 2017 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Methodist Medical Center of Illinois CurrentSince Aug 1, 2017 Accepting new patients

Locations

133 Spinder Dr
East Peoria, IL 61611
Phone (309) 265-7287

695 N Kellogg St
Galesburg, IL 61401
Phone (309) 343-8131

120 NE Glen Oak Ave
Ste 400
Peoria, IL 61603
Phone (309) 671-3519

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281

Organizations & group practices 4

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.

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": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575072000000",
    "number": "1417401985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 960347",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731960347",
            "telephone_number": "309-672-5522"
        },
        {
            "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",
            "fax_number": "309-308-5102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "221 NE Glen Oak Ave",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "IL",
            "postal_code": "616360001",
            "country_code": "US",
            "telephone_number": "309-672-5522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHAFER",
        "first_name": "KERRI",
        "middle_name": "JEAN",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2019-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209-014593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Peoria, IL

Sources for this page

Verify at the official NPI Registry.