Individual provider Active NPI

Alesia Eaton, NNP

  • Neonatal Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1477587426
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
209030812 Issued in IL
Practice address
530 NE Glen Oak Ave
Peoria, IL 61637-3561
Phone
(309) 655-2000
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X AP106521 TX
Critical Care Neonatal Nurse Practitioner 363LN0005X 540139 TX
Neonatal Nurse Practitioner 363LN0000X 209030812 IL Primary

Addresses

Primary practice location

530 NE Glen Oak Ave
Peoria, IL 61637-3561

Mailing address

5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561
Phone (210) 541-8281

Other practice location 1

5414 Fredericksburg Rd
Suite 100
San Antonio, TX 78229-3641
Phone (210) 541-8281 ext. 221

Other practice location 2

5430 Fredericksburg Rd Ste 508
San Antonio, TX 78229-3561
Phone (210) 541-8281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, MN, IL3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20181107001451 WA Practitioner - Nurse Practitioner 1951655117 Reassigns benefits to 2 organizations
I20230501001522 MN Practitioner - Nurse Practitioner 1951655117 Reassigns benefits to 4 organizations
I20241030000879 IL Practitioner - Nurse Practitioner 1951655117

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6561MNMDPhysical Therapist
AP106521TXMDNeonatal Nurse Practitioner
540139TXMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Medical Center Specialty Physicians, LLC CurrentSince Sep 1, 2018 Accepting new patients
Healtheast Medical Research Insititue CurrentSince Apr 1, 2023 Accepting new patients
Fairview Express Care CurrentSince Apr 1, 2023 Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2023 Accepting new patients
Providence Health & Services Washington CurrentSince Apr 1, 2025 Accepting new patients
Fairview Express Care CurrentSince Apr 1, 2023 Accepting new patients
Providence Health & Services Washington CurrentSince Apr 1, 2025 Accepting new patients
Fairview Clinics CurrentSince Apr 1, 2023 Accepting new patients
Fairview Health Services CurrentSince Apr 1, 2023 Accepting new patients
Fairview Clinics Current Accepting new patients
Fairview Health Services Nurse Practitioner CurrentSince Apr 1, 2023 Accepting new patients
Fairview Health Services Current Accepting new patients
Healtheast Medical Research Institute Current Accepting new patients
Healtheast Medical Research Institute CurrentSince Apr 1, 2023 Accepting new patients
Commonspirit Washington Community Care Past Accepting new patients
Providence Health & Services Washington Past Accepting new patients
Magella Medical Associates Billing, Inc. Neonatal Past Accepting new patients
Citizens Medical Center County of Victoria Past Accepting new patients

Locations

13819 Hanson Blvd NW
Andover, MN 55304
Phone (763) 572-5700

1440 Duckwood Dr
Eagan, MN 55122
Phone (651) 406-8860

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1700 University Ave W
Saint Paul, MN 55104
Phone (612) 672-6740

1700 University Ave W
Fl 6
Saint Paul, MN 55104
Phone (651) 232-2273

914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

Organizations & group practices 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1477587426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5430 FREDERICKSBURG RD STE 508",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293561",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616373561",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5414 Fredericksburg Rd",
            "address_2": "SUITE 100",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293641",
            "country_code": "US",
            "telephone_number": "210-541-8281 x221",
            "fax_number": "210-541-9123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5430 Fredericksburg Rd Ste 508",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293561",
            "country_code": "US",
            "telephone_number": "210-541-8281",
            "fax_number": "210-541-9123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EATON",
        "first_name": "ALESIA",
        "credential": "NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "AP106521",
            "primary": false
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "TX",
            "license": "540139",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "IL",
            "license": "209030812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.