Individual provider Active NPI

Brittany Ziller, APN

  • Nurse Practitioner
  • Bloomington, IL
National Provider Identifier
1528722089
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209.024250 Issued in IL
Practice address
2111 E Oakland Ave Ste B
Bloomington, IL 61701-5783
Phone
(309) 808-3068
Fax
(309) 808-3072
NPI assigned
Oct 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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 209.024250 IL Primary

Addresses

Primary practice location

2111 E Oakland Ave Ste B
Bloomington, IL 61701-5783

Mailing address

408 W Pine St
Fairbury, IL 61739-1449
Phone (815) 848-9585

Other names 1

  • Brittany Wilson Former name

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
I20211214002322 IL Practitioner - Nurse Practitioner 9638569205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Womens Healthcare SCGroup PAC ID 9133379340, 8 clinicians

Practice addresses (Care Compare)

2111 E Oakland Ave
Suite B
Bloomington, IL 61701-5783
Phone (309) 808-3068

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.024250ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gibson Community Hospital Association Past Accepting new patients

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.

Hospital & facility affiliations 4

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": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1528722089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 W PINE ST",
            "city": "FAIRBURY",
            "state": "IL",
            "postal_code": "617391449",
            "telephone_number": "815-848-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 E OAKLAND AVE STE B",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015783",
            "telephone_number": "309-808-3068",
            "fax_number": "309-808-3072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZILLER",
        "first_name": "BRITTANY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-29",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.024250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "WILSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

Verify at the official NPI Registry.