Jocele Kelly Cassidy
Individual provider Active NPI Family Nurse Practitioner · Pekin, IL
NPI 1679450282 · NPPES record last updated Aug 18, 2025
Key facts
- NPI
- 1679450282
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 209032988 (IL)
- Practice address
- 2301 Court St
Pekin, IL 61554-5304 - Phone
- (309) 308-5100
- NPI assigned
- Aug 18, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Osf Multi-Specialty Group
Practice addresses (Care Compare)
3626 N Sheridan Rd
Peoria, IL 61604-1401
Phone (309) 308-5100
8600 State Route 91
Suite 130
Peoria, IL 61615-7829
Phone (309) 683-5050
Hospital & facility affiliations
- Saint Francis Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250827000599 | IL | Practitioner - Nurse Practitioner | 8628578218 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209032988 | IL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current |
Accepting new patients |
Locations
2301 Court St
Pekin, IL 61554
Phone (303) 308-5100
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1420 W Pioneer Pkwy
Peoria, IL 61615
Phone (309) 308-5195
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209032988 | IL | Yes |
Addresses
Primary practice location
2301 Court St
Pekin, IL 61554-5304
Mailing address
413 W Hudson St
Peoria, IL 61604-1519
Other providers in Pekin, IL
- Danny Roscoe Callahan
- Nels Calvert
- Katie J L Capel
- Carol Capper
- Donna Marie Cargill
- Central Il Chiropractic, LTD
- Central Illinois Arthritis and Rehabilitation Center PC
- Central Illinois Chiropractic, P.C.
- Champion Fitness, Inc
- Jayne Ann Cheffer
All providers in Pekin, IL · Family Nurse Practitioner in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.