Active NPI
Kenneth Arnett
- Allergy Physician
- Peoria, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- 036-064666
- Practice address
- 200 E Pennsylvania Ave
Peoria, IL 61603-3089 - Phone
- (309) 655-4184
- Fax
- (309) 624-8876
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician | 207KA0200X | 036-064666 | IL | Primary |
| Pulmonary Disease Physician | 207RP1001X | 036-064666 | IL | |
| Pediatrics Physician | 208000000X | 036-064666 | IL |
Addresses
Primary practice location
200 E Pennsylvania Ave
Peoria, IL 61603-3089
Mailing address
200 E Pennsylvania Ave
Peoria, IL 61603-3089
Phone (309) 655-4184
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036064666 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-064666 | IL | MD | Allergy Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Board of Trustees of the University of Illinois | Pediatrics | Current | Accepting new patients |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| The Board of Trustees of the University of Illinois | Current | Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
7694 Solutions Ctr
Chicago, IL 60677
200 E Pennsylvania Ave
Peoria, IL 61603
Phone (309) 624-4000
2900 N Knoxville Ave
Peoria, IL 61603
Phone (309) 308-2000
1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
200 E Pennsylvania Ave
Ste L01
Peoria, IL 61603
Phone (309) 655-4184
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
Organizations & group practices 6
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.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Anatomic Pathology Physician
- Chicago, IL
- NPI 1386863819
-
dba Medical Service Plan at Peoria
- Pediatrics Physician
- Peoria, IL
- NPI 1467425322
-
dba Occupational Health Service Institute (OHSI)
- Occupational Medicine Physician
- Chicago, IL
- NPI 1043727571
-
dba patton pharmacy and v&s variety
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
dba Gibson Area Hospital and Health Services
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326153600000",
"number": "1437249760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 E PENNSYLVANIA AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616033089",
"telephone_number": "309-655-4184",
"fax_number": "309-624-8876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 E PENNSYLVANIA AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616033089",
"telephone_number": "309-655-4184",
"fax_number": "309-624-8876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARNETT",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2012-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "IL",
"license": "036-064666",
"primary": true
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IL",
"license": "036-064666",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036-064666",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036064666",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
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 Jan 10, 2012; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.