Nicole Wakefield

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209028120 Issued in IL

Practice address

101 W University Ave
Champaign, IL 61820-3981

Phone

(217) 366-1255

NPI assigned

Aug 17, 2023

Last updated

May 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole McCoy Former name

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christie Clinic, PLLCGroup PAC ID 7719899319, 219 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nmccoyaprn408858@carlehiedirect.net
• Direct secure messaging: nmccoyrn268292@carlehiedirect.net

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.

• Christie Clinic, PLLC

  • Internal Medicine Physician
  • Champaign, IL
  • NPI 1871523829

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947

  Family Medicine

  Medicare reassignment NPD
• Hoopeston Community Memorial Hospital

  dba Hoopeston Physician Group

  • Internal Medicine Physician
  • Hoopeston, IL
  • NPI 1043683014

  Family Medicine

  Medicare reassignment NPD
• Hoopeston Community Memorial Hospital

  • Critical Access Hospital
  • Hoopeston, IL
  • NPI 1366480873
  NPD
• Hoopeston Community Memorial Hospital

  dba Charlotte Ann Russell Medical Center

  • Rural Health Clinic/Center
  • Hoopeston, IL
  • NPI 1578504544
  NPD

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1417730938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203909",
            "telephone_number": "217-366-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W UNIVERSITY AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618203981",
            "telephone_number": "217-366-1255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKEFIELD",
        "first_name": "NICOLE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209028120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "MCCOY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Haleigh D Wadsworth, APN
• Janel Christine Wager, LCPC
• Elizabeth Wagner, LCPC ATR-BC
• Lauren Wagoner, PHARMD
• Theron Waisath, DMD
• Wal-Mart Stores, Inc (Vision Center 30-1734)
• Angela Walder
• Louise Ellen Walder, MA CCC SLPL
• Jill Waldhoff, PHARMD
• Shane Waldhoff

• Nurse Practitioner in Champaign, IL
• Providers in Champaign, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.