Active NPI
Truc-Quynh D Kohlmeyer
- Neonatal Nurse Practitioner
- Peoria, IL
National Provider Identifier
1609724210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 209035003
- Practice address
- 530 NE Glen Oak Ave
Peoria, IL 61637-0001 - Phone
- (309) 624-0629
- NPI assigned
- Mar 19, 2026
- Last updated
- Apr 23, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 209035003 | IL | Primary |
Addresses
Primary practice location
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Mailing address
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Other names 1
- Quynh D Kohlmeyer
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
124 SW Adams St
Peoria, IL 61602-1308
530 NE Glen Oak Ave
Peoria, IL 61637-0001
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209035003 | IL | MD | Neonatal Nurse Practitioner |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776902400000",
"number": "1609724210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 NE GLEN OAK AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616370001"
},
{
"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": "616370001",
"telephone_number": "309-624-0629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLMEYER",
"first_name": "TRUC-QUYNH",
"middle_name": "D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-03-19",
"last_updated": "2026-04-23",
"certification_date": "2026-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "IL",
"license": "209035003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "QUYNH",
"last_name": "KOHLMEYER",
"middle_name": "D",
"code": "2",
"type": "Professional Name"
}
]
}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 Apr 23, 2026; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.