Individual provider Active NPI

Joshua Matthew Felts, PMHNP

  • Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1477187946
Registry record updated Feb 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209020903 Issued in IL
Practice address
7317 N Willow Lake CT
Peoria, IL 61614-8227
Phone
(309) 683-7373
Fax
(309) 691-4408
NPI assigned
Feb 24, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209020903 IL Primary

Addresses

Primary practice location

7317 N Willow Lake CT
Peoria, IL 61614-8227

Mailing address

4032 N Walrond Ave
Kansas City, MO 64117-1647
Phone (816) 564-0504

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
I20200323002847 IL Practitioner - Nurse Practitioner 9638507759 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Missouri, Kansas City, School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

7317 N Willow Lake CT
Psychiatry Psychol
Peoria, IL 61614-8227
Phone (309) 683-7373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209020903ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Multi-Specialty Group CurrentSince Mar 23, 2020 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients

Locations

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

1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195

7317 N Willow Lake Ct
Peoria, IL 61614
Phone (309) 683-7373

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1477187946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4032 N WALROND AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641171647",
            "telephone_number": "816-564-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7317 N WILLOW LAKE CT",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148227",
            "telephone_number": "309-683-7373",
            "fax_number": "309-691-4408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELTS",
        "first_name": "JOSHUA",
        "middle_name": "MATTHEW",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209020903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.