NPIMap

Organization Active NPI

Epiphany Womens Health PLLC

  • Multi-Specialty Clinic/Center
  • Peoria, IL
National Provider Identifier
1609657311
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
EPIPHANY WOMENS HEALTH PLLC
Practice address
5008 N Glen Park Place Rd Ste B
Peoria, IL 61614-4695
Phone
(309) 306-1322
NPI assigned
Oct 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Authorized official

Name
William Marc Boyd, MDNPI 1770581456
Title
Owner
Phone
(309) 264-2046

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

5008 N Glen Park Place Rd Ste B
Peoria, IL 61614-4695

Mailing address

5008 N Glen Park Place Rd Ste B
Peoria, IL 61614-4695
Phone (309) 306-1322

National Provider Directory

National Provider Directory

Locations

5008 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 662-8045

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1696809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696809600000",
    "number": "1609657311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5008 N GLEN PARK PLACE RD STE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144695",
            "telephone_number": "309-306-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5008 N GLEN PARK PLACE RD STE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144695",
            "telephone_number": "309-306-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIPHANY WOMENS HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-09",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-264-2046",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.